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目的 :通过对 10 0侧腹股沟区标本的解剖观察 ,研究疝的发病和疝修补术的复发的解剖学因素。方法 :用福尔马林固定的尸体常规解剖和 4～ 10倍的解剖放大镜进行观察。疝修被术中使用 2 5～ 50 m A- V(毫安 -伏 )电刺激此肌束观察生理反应。结果 :发现自提睾肌发出一肌束 ,由外上向内下以腱膜性结构抵止于耻骨结节 ,将其命名为“提睾肌耻骨束”,出现率为 10 0 % ,此肌束由生殖股神经的生殖支支配。用直流电刺激此肌束或生殖股神经的生殖支 ,可出现肌束收缩并使弓状下缘向腹股沟韧带靠拢 ,导致弓状下缘下方的肌肉缺损间隙变小。结论 :证实了以往提及的“掩闭器机理”和内环的“括约肌机能”主要是由于此肌束的收缩所致。疝修补术时保留此肌束可减少疝的复发。
OBJECTIVE: To study the anatomic factors of the incidence of hernia and the recurrence of hernia repair, based on the anatomical observation of 100 inguinal region specimens. Methods: We used formalin-fixed autopsy and 4 ~ 10 times dissecting magnifying glass to observe. Herniorrhaphy was performed using an electric stimulation of 25-50 m A-V (milliampere-volt) to observe the physiological response. Results: A muscle bundle was found from the cremaster muscle. From the outside to the inside, the aponeurotic structure reached the pubic nodules, which was named as “cremaster muscle pubic bundle”, with an incidence of 10% Muscle bundles reproductive branch by the reproductive nerve branch. DC stimulation of the muscle bundle or genital nerve reproductive branch, muscle bundle contraction can occur and the armpit edge closer to the inguinal ligament, resulting in lower arched lower edge of the muscle defect gap smaller. Conclusions: It was confirmed that the “occluder mechanism” previously mentioned and the “sphincter function” of the inner ring are mainly due to the contraction of this bundle. Hernia repair to retain this muscle bundle can reduce the recurrence of hernia.