肿胀麻醉液在大隐静脉高位结扎及剥脱术中应用.docVIP

肿胀麻醉液在大隐静脉高位结扎及剥脱术中应用【摘要】 目的 探讨肿胀麻醉液在大隐静脉高位结扎剥脱术中应用的疗效。方法 随机选择30例大隐静脉高位结扎剥脱术患者应用肿胀麻醉液术中冲洗静脉剥脱后的残腔与30例未使用肿胀麻醉液冲洗残腔的患者术后疗效做对比分析，评价肿胀麻醉液在大隐静脉高位结扎和剥脱术中的应用疗效。结果 观察组(使用肿胀麻醉液)在术区疼痛、皮下淤血及术区硬结或索条方面明显优于对照组。结论 肿胀麻醉液应用于大隐静脉高位结扎和剥脱术中，疗效可靠，安全、方便。 【关键词】 肿胀麻醉液；大隐静脉高位结扎和剥脱术 The Application of tumescent Anesthesia fluid in the main saphenous vein ligation and decortication ZHANG Zhi-ping, LI Ming-zhang, ZHANG mao.Department of General Surgery,Baotou Central Hospital of Inner Mongolia,Baotou 014040,China 【Abstract】 Objective Investigate the efficacy of the application of tumescent fluid in the saphenous vein ligation and decortications. Methods Randomly selected 30 cases of the saphenous vein high ligation of endarterectomy patients by using tumescent fluid in the operation to wash the residual cavity after the vein stripping, and 30 cases of patients who without using tumescent fluid washing, compare and analyze the efficacy after the operation, evaluate the function of tumescent fluid in the saphenous vein ligation and decortications. Results The cases by using tumescent fluid in operation in surgery pain, subcutaneous ecchymosis and surgery area indurations are better than the cases without using. Conclusion It is effective and reliable, safe and convenient by using tumescent fluid used in the saphenous vein ligation,endarterectomy. 【Key words】 Tumescent fluid; The saphenous vein ligation and decortication 大隐静脉高位结扎、剥脱术作为外科治疗大隐静脉曲张传统手段，其疗效已经得到一致认可，但术后患者会有术区疼痛、皮下淤血及大隐静脉剥脱后遗留残腔，形成硬结或条索，影响术后恢复。目前国内外已有将肿胀麻醉液注射于静脉周围应用于大隐静脉相关手术操作。我院借鉴肿胀麻醉液在美容医学中的应用原理，将肿胀麻醉液应用于大隐静脉高位结扎、剥脱术，术中冲洗静脉剥脱术后所致残腔，取得满意疗效，现报告如下。 1 资料与方法 1.1 一般资料 选择60例单侧下肢大隐静脉曲张患者行大隐静脉高位结扎和剥脱术患者，随机分成观察组和对照组各30例。观察组男14例，女16例，年龄43岁～75岁，平均年龄61岁；对照组男12例，女18例，年龄45岁～73岁，平均年龄62.5岁。两组患者性别、年龄、发表时间及病变程度及血液流变学指标无统计学意义。 观察组中所使用肿胀麻醉液均采用在500 ml生理盐水中加入2％利多卡因10 ml、肾上腺素0.5 mg、5％碳酸氢钠10 ml。 1.2 方法 使用组30条患肢行大隐静脉高位结扎和剥脱术时，剥脱器尾端连接带侧空输液器(术中修剪)作为冲洗导管，待剥脱大隐静脉后，冲洗导管随剥脱器进入大隐静脉剥脱后遗留残腔中，用配制好的500 ml肿胀麻醉液持续快速冲洗，冲洗完毕，间断排挤余液，缝合切口，大隐静脉走行区立即予以加压包扎；