腹股沟疝微创手术在西藏地区的推广应用及历史意义

The promotion application and historical significance of minimally invasive surgery for inguinal hernia in Tibet

  • 摘要: 西藏自治区(以下简称西藏)位于祖国边疆,自然环境恶劣,平均海拔>4 000米,目前常住人口约365万,分布在120多万平方公里的土地上,地广人稀,医疗资源配置难度异常艰难。上述客观原因使西藏地区患者及时就医难度大,就诊时合并多种并发症。单从腹股沟疝疾病而言,腹股沟疝嵌顿患者比例较高。因基层就医条件差,患者就医意识欠佳,对疾病的认识不足,因此,常发生腹股沟疝嵌顿引起的严重并发症,甚至死亡。伴随临床指南的发布、器械与材料的进步、治疗理念和解剖认识的更新,腹腔镜腹股沟疝修补术得到大力推广。西藏地区医疗新技术推广较为滞后。近年来在中国医师协会外科医师分会疝和腹壁外科医师委员会和中华医学会外科学分会疝和腹壁外科学组的大力支持下,自2016年开始在西藏拉萨推广疝相关的微创治疗,特别是腹股沟疝的微创治疗。目前微创技术治疗腹股沟疝已广泛推广至西藏各地区三级医院,通过宣传,广大患者能够及时就医,显著降低腹股沟嵌顿疝发生率。笔者查阅文献并结合临床实践,探讨腹股沟疝微创手术在西藏地区的推广应用及历史意义。

     

    Abstract: The Tibet Autonomous Region (hereinafter referred to as Tibet) is located on the border of the country, with a harsh natural environment and an average elevation of over 4 000 meters. Currently, the total permanent population of the region is about 3.65 million, distributed over 1.2 million square kilometers of land. The land is vast and sparsely populated, making it extremely difficult to allocate medical resources. The above objective reasons make it difficult for patients in Tibet to seek medical treatment in a timely manner, and there are multiple complications when seeking medical treatment. In terms of inguinal hernia disease, the proportion of patients with inguinal incarcerated hernia is relatively high. Due to poor medical conditions, patients have poor awareness of seeking medical treatment, and lack of understanding of the disease, leading to serious complications and even death caused by inguinal incarcerated hernia. With the releasing of clinical guidelines, advances in equipment and materials, and updates in treatment concepts and anatomical understanding, laparoscopic inguinal hernia repair has been vigorously promoted. The promotion of new medical technologies in Tibet is relatively lagging behind. In recent years, with the strong support of the China Hernia Society and the Chinese Hernia Collegen of Surgeons, minimally invasive treatment related to hernia disease has been promoted in Lhasa since 2016, especially for inguinal hernia. At present, minimally invasive technology for treating inguinal hernia has been widely promoted to tertiary hospitals in Tibet. Through publicity, patients can seek medical attention in a timely manner, significantly reducing the incidence of inguinal incarcerated hernia. Based on litera⁃tures and clinical practice, the authors explore the promotion, application, and historical significance of minimally invasive surgery for hernia in Tibet.

     

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