局麻下无张力疝修补术治疗老年腹股沟疝的临床效果

李虎

（西安医学院附属汉江医院普外科，陕西 汉中，723003）

浏览次数：101次 下载次数：340次

摘要：

目的 探讨局麻下无张力疝修补术在老年腹股沟疝患者治疗中的效果。方法 将2012—2016年我院收治的86例局麻下无张力疝修补术老年患者纳入观察组，再选取同时期86 例硬膜外麻醉下的无张力疝修补术老年患者分为对照组，回顾性分析 两组患者的临床资料，比较两组患者的临床效果及并发症发生情况。结果 两组患者的手术时间、术中出血量及术后镇痛剂使用率比较，差异均无统计学意义（P>0.05）；但观察组患者的术后下床活动时间、住院时间均明显短于对照组（P<0.05）；观察组患者术后并发症总发生率明显低于对照组（P<0.05）。结论 与硬膜外麻醉方法相比，老年腹股沟疝患者采用局麻下无张力疝修补术治疗腹股沟疝具有操作简便、恢复快、并发症少等优势。

关键词：局麻；硬膜外麻醉；无张力疝修补术；老年腹股沟疝

中图分类号：R656.21文献标志码：A文章编号：2096-1413(2017)32-0068-02

Clinical effect of tension-free hernioplasty in the treatment of elderly inguinal hernia under local anesthesia
LI Hu
(Department of General Surgery, Hanjiang Affiliated Hospital of Xi``an Medical University, Hanzhong 723003, China)

ABSTRACT: Objective To investigate the effect of tension-free hernioplasty in the treatment of elderly inguinal hernia under local anesthesia. Methods Eighty -six elderly patients with tension -free hernioplasty under local anesthesia from 2012 to 2016 in our hospital were included in the observation group, another 86 elderly patients with tension-free hernia repair under epidural anesthesia were included in the control group. The clinical data of two groups were retrospectively analyzed, and the clinical effects and complications of the two groups were compared. Results There were no significant differences between the two groups in the operation time, intraoperative blood loss and postoperative analgesic use rate (P>0.05). The postoperative ambulation time and hospitalization time of the observation group were significantly shorter than those of the control group (P<0.05). The total incidence of postoperative complications in the observation group was significantly lower than that in the control group (P <0.05). Conclusion Compared with epidural anesthesia, tension -free hemioplasty under local anesthesia for elderly inguinal hernia has the advantages of simple operation, rapid recovery and less complications.
KEYWORDS: local anesthesia; epidural anesthesia; tension-free hemioplasty; elderly inguinal hernia

参考文献：
[1] FRANKLIN ME JR,TREVI O JM,PORTILLO G,et al.The use of porcine small intestinal submucosa as a prosthetic material for laparoscopic hernia repair in infected and potentially contaminated fields: long-term follow-up[J].Surg Endosc,2008,22(9):1941-1946.
[2] 姜正科,朱顺福,俞晓军,等.开放式腹膜前间隙无张力疝修补术治 疗腹股沟疝的临床疗效分析[J].中华疝和腹壁外科杂志:电子版,2016,10(3):172-174.
[3] 刘文进.老年腹股沟疝腹膜前间隙无张力疝修补术不同麻醉方式 的研究[J].大家健康(旬刊),2016,10(3):154-155.
[4] NAGAHISA Y,HOMMA S,CHEN K,et al.Feasibility of a new approach for creating a preperitoneal space in transabdominal preperitoneal repair inguinal hernia repair: using a sandwich approach[J].Surg Today,2017,47(5):595-600.
[5] 吴跃辉,洪磊.两种补片在腹股沟疝无张力修补术中的研究[J].安徽卫生职业技术学院学报,2013,12(1):55-56.
[6] PATIL SM,GURUJALA A,KUMAR A,et al.Lichtenstein mesh repair (LMR) v/s Modified bassini``s repair (MBR) + lichtenstein mesh repair of direct inguinal hernias in rural population: a comparative study[J].J Clin Res,2016,10(2):PC12-15.
[7] 王阿勇,康利民,郑永.开放式TEP 治疗腹股沟无张力疝修补术后复发疝的临床观察(附8 例报告)[J].临床研究,2016,24(2):199.
[8] 杨栋,吴晓明,刘丰,等.腹股沟疝腹腔镜下修补术与无张力修补术应用于老年患者的综合疗效研究[J].现代生物医学进展,2016,16(18):3492-3495.
[9] 刘卫东.无张力疝修补术与传统疝修补术对照研究[J].中国临床研究,2011,24(8):691-692.
[10] 王保起,王国栋,冯振同,等.局部麻醉腹股沟疝无张力修补日间手 术63 例临床分析[J].中国全科医学,2009,12(13):1219-1220.
[11] NORDIN P,HERNELL H,UNOSSON M,et al.Type of anaesthesia and patient acceptance in groin hernia repair: a multicentre randomized trial[J].Hernia,2004,8(3):220-225.
[12] 李宏武,张德巍,陈静,等.局部麻醉下无张力疝修补术治疗中老年 腹股沟疝的体会[J].中国现代普通外科进展,2015,18(1):53-54.