低浓度利多卡因肿胀麻醉在体表大面积病变组织切除中应用.docVIP

低浓度利多卡因肿胀麻醉在体表大面积病变组织切除中应用[摘要]目的:探讨低浓度利多卡因肿胀麻醉在体表大面积病变组织切除手术中的应用效果。方法:对22例体表大面积病变,其中神经纤维瘤11例、下肢淋巴水肿2例、巨痣9例,应用含0.02%利多卡因的低浓度肿胀麻醉技术,将病变组织完整或大部切除,观察其临床效果。结果:所有病例术中麻醉满意、出血少、手术时间缩短、术后早期疼痛轻。结论:在体表大面积病变组织切除手术中局部注射低浓度肿胀液,术中出血少、降低了手术风险、术后恢复快,是一种简便、安全、有效的方法。 [关键词]肿胀麻醉;体表肿块;切除 [中图分类号]R971+.2[文献标识码]A[文章编号]1008-6455(2010)06-0830-02 Application 0f tumescent anesthesia with the lower lidocaine concentration in the surgical treatment 0f superficial large pathological tissue ZHAO Li-ping,WANG Ming-gang,DU Xiao-yang,YU Gang,WANG Hong-yuan (Department of Plastic Surgery,Anhui Provincial Hospital,Anhui Medical University,Hefei 230001,Anhui, China) Abstract:0bjectiveTo explore the clinical significance of tumescent anesthesia with the lower lidocaine concentration in the surgical treatment 0f superficial large pathological tissue.MethodsResection was applied to treatment of 11 cases neuroinoma, 2 cases lymphedema in lower limb and 9 cases giant nevus under tumescent technique with 0.02% lidocaine concentration, the clinical significances of this approach was discussed. Results Satisfactory results were obtained in 17 cases with good effect of anaesthesia,less bleeding,shorter operation time and early allevation of pain after operation ConclusionThe 0peration with tumescent anesthesia containing0.02% lidocaine is an effectiveand safe method for patients with superficial large pathological tissue, It is easily performed with less bleeding and risk,and postoperative recovery is quickiy. Key words:tumescent anesthesia;superficial pathological tissue;resection 肿胀麻醉已经广泛应用于各类整形美容手术中,在体表病变组织的手术中应用肿胀麻醉不仅剥离层次清晰而且出血少,但对于体表大面积病变组织,术区注射超量的肿胀液会引起利多卡因的毒性反应,自2006年以来,笔者在11例神经纤维瘤、2例下肢淋巴水肿、9例巨痣切除手术中,向术区注入利多卡因浓度为0.02%的超低浓度肿胀液后再剥离,术中心电监护,对其临床效果进行观察。 1临床资料 本组22例患者,男性10例,女性12例,年龄16～48岁,平均年龄29岁。病程3～16年,神经纤维瘤及巨痣大小从20cm×28cm～60cm×82cm,2例下肢橡皮肿的病变范围为整个下肢,所有患者均排除心、肝、肾功能及凝血功能障碍。肿胀液注射量为15O0～2500ml。 2方法 2.1 肿胀液的配制:0.9%生理盐水100Oml,2%利多卡因10ml,5%碳酸氢钠1Oml,0.1%盐酸肾上腺素1mg,根据肿块大小决定肿胀液的用量。