肉膜囊睾丸固定术治疗成人隐睾36 例体会.docVIP

精品论文 参考文献 肉膜囊睾丸固定术治疗成人隐睾36 例体会 张杨罗旭张绪连 （遵义医学院附属医院泌尿外科563003） 【摘要】探讨肉膜囊睾丸固定术在成人隐睾治疗中的运用。方法：选取16岁及以上隐睾患者行睾丸下降肉膜囊固定治疗，采用腹股沟斜切口，寻找到睾丸，结扎疝囊后松解精索，充分游离精索后将睾丸牵引至分离扩大的阴囊底部，行肉膜囊睾丸固定。结果：36例隐睾患者应用肉膜囊固定法顺利完成，其中4例双侧隐睾患者均采用肉膜囊固定法完成。睾丸复位良好，睾丸萎缩发生率低，阴囊饱满。结论：肉膜囊固定法创伤小、恢复快、睾丸复位成功率高、疗效满意。 【关键词】成人隐睾；肉膜囊睾丸固定术 【中图分类号】R2 【文献标号】A 【文章编号】1671-8725（2014）12-0124-02 Discussion on Dartos Orchiopexy for Adult Cryptorchidism in 36 TestesZhang Yang，Lou Xu，Zhang Xu-lian（Department of Urology，the First Affiliated Hospital of Zunyi Medical College，Zunyi 563003，China）abstract:The author explored dartos orchiopexy applied in the treatment of adult cryptorchidism. Methods: 36 cryptorchids aged 16 and over were underwentdarots orchiopexy. Firstly, through oblique groin incision, found out the testicles and released spermatic cordafter ligation of the hernia sac. Secondly,fully freed spermatic cord, and then with the testis traction to the bottom of the separated and enlarged scrotum, performed dartos orchiopexy.Results: 36 cases used darots orchiopexy were successfully completed, in which 4 patients with bilateral cryptorchidism were also underwent darots orchiopexy.And in the 36 cases, reduction of tests had positive effect, incidence of testicular atrophy was low and scrotum remained full. Conclusion: DartosOrchiopexy causes less trauma, brings quick recovery, high success rate of testicular reduction, and satisfactory results.Keywords: Adult cryptorchidism; Dartos Orchiopexy 我院2009年9月至2013 年5月采用隐睾下降、睾丸肉膜囊固定治疗隐睾36 例，最终患者病情收到良好疗效，现报告如下。 1 资料与方法 1.1 临床资料 本组隐睾患者36例，左侧20 例，右侧12例，双侧4例。年龄16-38岁。平均年龄25 岁。术前体检及阴囊超声检查诊断为隐睾。 1.2 手术方法 患者采取腰硬联合麻醉，取仰卧位，经腹股沟韧带上方2cm 处作皮肤切口，分离皮下筋膜，打开腹股沟管，寻找睾丸，合并腹股沟斜疝者，游离疝囊后将其高位结扎。松解精索时保护滋养血管，切断睾丸引带，使其达到阴囊底部。分离阴囊，用手指从切口下角的腹壁深筋膜深面向阴囊分离，直达阴囊底部。于阴囊底部作皮肤切口，在皮肤与肉膜间分离空隙，切开肉膜达阴囊腔。精索改道，于腹壁下血管内侧切开腹横筋膜，分离通道，将睾丸及精索经此置入阴囊腔，拉出阴囊切口之外。固定睾丸，缝合肉膜切口，使仅容精索通过。将睾丸置入阴囊皮下腔隙内，三针固定睾丸于肉膜腔内，缝合阴囊皮肤切口。 2 结果 36 例（