疝

objective: value the no tention hernia ring padding neoplasty in treating inguinal hermia.method: retrospectively analysize the clinical data of the no tention hernia ring padding neoplasty.result:the average time of the neoplasty is 40 minutes,the patients can make out-of-bed activity ,whom were treated after 6 hours.all of the patients were free of infection.2 patients felt foreign body sensation in inguinal groove and 1 person felt benumbed.conclusion: no tention hernia ring padding neoplasty is a valuable type of neoplasty,which operates simply,and the patients can get little injury ,rapid recovery and low relapse rate.

目的：探讨无张力疝环填充式修补术在腹股沟疝手术中的应用价值。方法：对30例腹股沟疝患者行无张力疝环填充式修补术后的临床资料进行回顾性分析。结果：手术时间平均40 min，切口疼痛2 d～7 d，术后6 h下床活动，无感染病例，腹股沟异物感2例，麻木1例。结论：疝环填充式无张力修补术是一项更符合生理解剖结构的治疗技术，操作简单，损伤小，恢复快，复发率低。

Results: Both sides of elder hernia sac became constrictive because of fibrosis caused by A ring, C ring chronic inflammation, which made hiatal hernia sac dilate like a expanded balloon, 7 cases were manifested stenotic at the two ends. Lithiasis in the hiatal hernia sac display of filling defect the same as the smoothly sac without aerogenic powder. Long axis of filling defect were accorded with that of esophagous, the sign could be described as "cast mould" of esophagous hiatal hernia sac.

结果：由于老年性疝囊两端的A环、C环在长期慢性炎症的刺激下纤维化而狭窄，使疝囊膨胀表现为&吹气球征&，7例疝囊上下两端狭窄。7例疝囊内结石未服用产气粉前表现为与疝囊同等大小且边缘光滑的充盈缺损，充盈缺损的长轴与食道长轴方向基本一致，呈现&食管疝囊铸型征&。

Results 12 cases as abdominal hernia (of which indirect hernia 9 cases, direct hernia 2 cases, femorocele 1 case), ultrasonography shows middle-high echo or linkage heterogeniety echo clumps; 8 cases as hydrocele, Ultrasonogram shows anechoic; 2 cases as cryptorchidism, ultrasonography shows normal testicular middle-echo; 4 cases as lymph node mass (of which lymphoma 2 cases, lymph node metastasis 1 case, lymph node inflammatory change 1 case), acoustic image shows low weak echo; 4 cases as substance mass (of which fibroma 1 case, spermatic cord tumor 1 case, Desmoid tumor 1 case, spermatic cord inflammation 1 case), Ultrasonography shows non-uniformity middle-highor low echo.

结果 12例为腹外疝（其中斜疝9例、直疝2例、股疝1例），声像图表现为中高回声或混杂性回声团块；8例为鞘膜积液，声像图表现为无回声；2例为隐睾，声像图表现为似正常睾丸样中等回声；4例为淋巴结包块（其中淋巴瘤2例、淋巴结转移1例、淋巴结炎性改变1例），声像图表现为低弱回声；4例为实质性包块（其中纤维瘤1例、精索肿瘤1例、韧带样瘤1例、精索炎症1例），声像图表现为非均匀性中高回声或低回声。

Methods:Clinical data of 32 cases of laparoscopic herniorrhaphy for inguinal hernia was analyzed retrospectively.

回顾分析行腹腔镜腹股沟疝修补术32例患者的临床资料，其中斜疝27例，直疝4例，复合疝1例。

Hernia sac/freeing ------ Search for associated hernias In cases of voluminous direct hernias, a thorough exploration of the groin is necessary to rule out any coexisting intraparietal, low lying Spieling or femoral hernias.

在巨型直疝时，需彻底探查腹股沟区以排除任何合并存在的腹壁间裂隙疝、低位的外侧腹壁疝（Spigelian 疝）或股疝。

Modified Kugel patch repair is conducive to resolving the weakness of myopectineal orifice which is the anatomical basis of inguinal hernia, it is a fundamental resolution to the characteristics of a variety of hernia co-exist and recurrence easily, so it is a better repair with the advantage of thorough treatment, recovery rapidly, fewer complication, and lower recurrences.

改良Kugel腹股沟疝修补技术是针对于解决耻骨肌孔结构薄弱及缺损这一腹股沟疝发生的解剖学基础的腹股沟疝修补技术，具有手术彻底、术后恢复快、并发症少、复发率低的优点，从根本上解决腹股沟疝患者多种疝并存及术后容易复发的特点，是目前腹股沟疝治疗中较理想的手术方式。

Sigmoid mesocolon hernias account for 6% of all internal hernias (1 3) and are divided into three categories (45): intersigmoid hernia, trans mesosigmoid hernia, and intermesosigmoid hernia.

乙状结肠系膜疝占所有腹内疝的6%，可以分为3类：乙状结肠间疝；经乙状结肠系膜疝和乙状结肠系膜间疝。

Results One case with transverse mesocolon pore hernia, one with obturator hernia and one with paracecal hernia were confirmed by exploratory laparotomy. There were six cases whose hernias resulted from the fall of export jejuna into import jejuna after Billroth II anastomoses in front of colons, five from the pelvic bottoms' peritoneal fissure and four from the fissure appearing between descending colon and lateral abdominal wall after Miles' operation, one from greater omental adhesion to sigmoidal wall after sigmoidostomy, and one from inflammatory adhesion on the basis of Meckel's diverticulum. The other 17 cases' hernias (48.7%) were caused by the fissure among celiac adhesive bands, peritonea, celiac organs, enteric walls and intestines.

结果 剖腹探查手术证实为横结肠系膜裂孔疝1例；闭孔疝1例；盲肠旁疝1例；毕Ⅱ式结肠前吻合术后输出段空肠疝入输入段空肠与横结肠系膜间隙6例；Miles术后盆底腹膜裂开所致内疝5例；Miles术后降结肠与侧腹壁形成的间隙致内疝4例；大网膜与乙状结肠造口肠壁粘连形成内疝1 例；1例在梅克尔憩室基础上发生炎性粘连形成腹内疝；因腹腔粘连带与腹膜、腹腔脏器、肠壁、肠与肠之间的孔隙改变形成内疝17例（48.7%）。

A = foramen of Winslow hernia, B = left paraduodenal hernia, C = right paraduodenal hernia, D = transmesenteric hernia, E = pericecal hernia, F = transomental hernia, G = intersigmoid hernia.

图1 示意图显示上腹腔和下腹腔腹内疝的部位和方向。A，Winslow孔疝；B，左侧十二指肠旁疝；C，右侧十二指肠旁疝；D，肠系膜疝；E，盲肠旁疝；F，网膜疝；G，乙状结肠疝。

Pelvic hernias include hernias through the broad ligament, perirectal fossa, and fossa of Douglas.

盆腔疝包括阔韧带疝、直肠旁疝和Douglas窝疝。

I use an example quoted by Hu Jiaqi:"It is reported that America separates the DNA of a kind of virus by making use of genetic technology and combines it with another kind of DNA. Finally, they get a kind of virulent biological agent called a "pyrotoxin". Someone discloses in private that 20 grams of such a kind of biological agent could result in the global death of 6 billion people due to infection."

我在这里例举胡家奇所引用过的例子："据报道，美国利用转基因技术，将一种病毒的DNA分离出来，与另外一种DNA进行结合，拼结成一种剧毒的"热毒素"生物战剂，且私下有人透露，这种生物战剂只需20克，就可以导致全球60亿人全部感染死亡。"

Waiting, for the queers and the coons and the Reds and the Jews.

等待着疯子和黑人还有红色共产主义者还有犹太人