腹股沟斜疝与直疝的超声鉴别诊断

目的探讨腹股沟斜疝与直疝的超声鉴别方法及其在腹腔镜疝修补术中的应用价值。方法对我院普外科住院拟行腹腔镜腹股沟疝修补术的106例患者行术前高频超声检查，确认腹壁下动脉与腹股沟疝的关系，凡疝囊自腹壁下动脉外侧、前方通过者诊断为斜疝，而疝囊自腹壁下动脉内侧通过、将其向外前方推挤者诊断为直疝。超声诊断与腹腔镜疝修补术结果比较。结果腹股沟疝患者共106例。其中超声诊断腹股沟斜疝94例，直疝12例，纠正术前临床误诊3例。术前超声诊断明确，106例均经手术证实。结论高频超声能准确鉴别腹股沟斜疝与直疝，有效指导腹腔镜疝修补术。

The differential diagnosis of indirect inguinal hernia and direct inguinal hernia by ultrasound

Objective To explore the method and diagnostic accuracy of inguinal region hernia by uhrsound and the value in laparoseopie inguinal hernia repair（LIHR）. Methods A total of 106 patients who planned to have LIHR between May 2006 and May 2007 were included in this study. By high-frequency trandueer, we scanned the inguinal region to explore the relationship between hernia and inferior epigastric artery（IEA）. Indirect inguinal hernia （IIH） was diagnosed with lateral protruding hernia and anterior to IEA. While the direct inguinal hernia （DIH） was medially originated to the IEA that it was laterally and anteriorly pushed by the DIH. The ultrasonic diagnosis was compared with surgical results. Results There were 106 patients with inguinal region hernia including 94 IIHs and 12 DIHs diagnosed by ultrasound and 3 cases corrected by ultrasound before surgery. The ultrasonic diaguosises were accurate and all of 106 cases were confirmed by surgery. Conclusions The high-frequency ultrasound can precisely differentiate IIH from DIH, which is an effective guidance for LIHR.