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妊婦さんや中高年の皆さんは要注意!白線ヘルニアって何?

はてな

「白線ヘルニア」聞き慣れないヘルニアですね。始めて聞く方も多いのではないでしょうか。このヘルニアには別名がついていて、それを「正中腹壁」と言います。乳児や妊娠中の方、中高年のお腹の出た方によくあるヘルニアです。緊急を要する病気ではありませんが、痛みがひどくなる場合があります。

今回は白線ヘルニアの治療と問題点について調べてみました。

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白線ヘルニアとは

見て

まず「白線」ってどこだか知っていますか?この白線とは、おへそを通る、丁度お腹の中心線の事です。そもそもヘルニアとは、体内の臓器などが、本来あるべき部位から脱出した状態を呼びます。いわゆる「でべそ」も正式には臍ヘルニアという病名がついています。

白線ヘルニアは、お腹の中心の筋肉の上にある腹直筋筋膜に小さな隙間があり、そこから身体の内容物が脱出してしまう事を言います。乳児の場合は立つと目立つので、2~3歳ごろに美容の意味で手術をする事をすすめられます。

中高年の場合は、普段は痛みはなくても、運動などをした時に激しく痛む場合があります。大人の場合一般的な治療法は手術で、脱出してしまった内容物を適切に処置した後、白線を縫い合わせることになります。

最近では、手術の技術も進歩してきましたので、入院日数は3日程度に短縮されてきています。中には、日帰りでも可能というところもあるようですから、お腹部分の手術ではありますが、それほど大がかりなものではないと言うことでしょう。

白線ヘルニアの症状

白線ヘルニアでは、白線と呼ばれている腹直筋筋膜の小さな隙間から体の内容物が脱出することが確認されます。自覚症状がないことが多いのですが、運動時や入浴時などに痛みを感じることもあります。

仰向けになった際に腹部にコブやしこりのようなものが気になるという違和感を訴える場合もあります。お腹に力を入れると膨らんだり、食後膨らんだり、腹痛、下痢が発生する場合もあるので注意が必要です。

白線ヘルニアの検査

白線ヘルニアの検査方法として最も行われているのは超音波検査です。この超音波検査を行うことにより、ヘルニアの症状があるかどうかを明確に判断できます。また、全方向からの検査が可能であるため、所見が分かりづらい部位に発症している場合でも容易に発見することが可能です。検査にかかる時間は比較的短時間であり、簡単に検査を進めることができます。

白線ヘルニアの治療方法

白線ヘルニアの治療法は外科手術によって問題箇所を切除することです。初期段階で違和感を感じ始めた頃は問題箇所にサポーターなどをして腹にかかる力が均等にして患者にかかる負担を軽減します。普段の生活でも腹には余計な圧力がかからないように注意して生活し、腹周辺を保護します。サポーターでも抑えきれない状態になったら外科手術で切除します。

妊婦の方の場合

妊娠中、または出産時に「腹筋が裂ける」ことを、「腹直筋離開」といいます。

感じ方としては、以下のようにおっしゃる方が多いです。

・腹筋がさけている
・おなかが変な感じがする
・おなかに力が入らない
・おなかの筋肉がおかしい
・横になると、おなかが垂れる
・おなかが動く
・おなかに亀裂がある
・四つ這いになると、おなかが垂れる
・内臓が支えられていないような感じがする
・でべそが治らない
など

腹直筋というのは、お腹の筋肉で、一番表面にある筋肉のことです。お腹に力を入れると、板チョコのように、お腹が割れる人がいますが、その筋肉が腹直筋です。その腹直筋が、妊娠に伴う子宮の増大で、筋膜と腱膜が緩みます。そして、真ん中から左右に裂けてしまうことがあり、それを「腹直筋離開」というのです。2㎝または、指2本の幅よりも広い離開は重大だと考えられています。

腹直筋離開と合併して、白線ヘルニアが生じることがあります。おなかを支える筋肉がうまく働かなくなるため、食後は腸が動くのを感じたり、おへそが出てきたり、さらにおなかがぽっこり出てきたら、ヘルニアを疑ってみましょう。食前後でこのような変化が出る方は、ヘルニアの可能性が高くなるため、注意が必要です。

乳児の白線ヘルニア

乳児の場合は臍ヘルニアと白線ヘルニアと判断が難しい場合があります。お腹に筋肉がつけば自然に治る場合もあれば、10円玉の大きさを超える場合は、手術をする場合もあります。痛みはなく、立っていると目立つという症状が殆どですが、心配な場合は小児外科で相談されると良いでしょう。

まとめ

もともとヘルニアとは、体のいろいろな部分で臓器または組織が飛び出す(脱出した)状態をいいます。歳をとるとお腹の筋肉が内蔵を支える力が衰え、内蔵が下がってお腹の辺りに貯まってくるので特に注意が必要です。妊婦の方や乳児は体型上白線ヘルニアになりやすいと言えますが、筋肉をつけたり、効果のあるストレッチなどで改善できます。

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