局部浸润麻醉在老年腹股沟疝网塞修补术中的临床应用情况.docVIP

局部浸润麻醉在老年腹股沟疝网塞修补术中的临床应用 【摘要】 目的 探索局部浸润麻醉在老年患者腹股沟网塞修补术中的临床应用疗效。方法 回顾性分析2015年12月至2016年5月，宿迁市第一人民医院40例在局部阻滞麻醉下实施的老年腹股沟疝网塞充填式修补术患者，观察术中疼痛情况、术后疼痛情况、手术时间、下床活动时间、平均住院时间以及术后并发症的发生情况。结果 所有患者均顺利完成手术，术中发生中重度疼痛(VAS级评分≥4)6例，平均手术时间(50±15)min，平均下床活动时间(3.8±1.2)h，术后发生切口浆液肿8例，阴囊积液2例，尿潴留1例，无切口感染发生，平均住院时间(3.0±1.5)d，术后随访3个月至6个无复发患者。结论对老年腹股沟疝患者应用局部浸润麻醉进行网塞修补术是安全、有效的，术中需要加强监护。 【关键词】疝，腹股沟；疝修补术；麻醉，局部；老年人 Clinical application of local nerve block anesthesia in inguinal hernia tension-free repair in elderly patients Yuan Xihong，Wang Jun，Li Jian，Zhou Kai．Department of General Surgery，the Campus 2 of People’S Hospital of Jiangxi Province，Nanchang 330006，China Corresponding author：Yuan舡幻增，Email：yuanxihong@126．con 【Abstract】Objective To explore the clinical effect of local block anesthesia in elderly patients with inguinal hernia repair．Methods A retrospective analysis on 68 casesof elderly patients in the Campus 2 of Peopleg Hospital of Jiangxi Province with inguinal hernia repair under local anesthesia was conducted，andthe intraoperative pain，operation time，time to ambulate，average hospitalization time and postoperative complications were observed．Results All operations were successfully completed．Intraoperative pain Wassevere or moderate(VAS score≥4)in 6 cases．The average operation time was(48±12)minutes，and the average time to ambulate was(3．8±1．2)hours．Postoperative wound seroma occurred in 8 cases，scrotal effusion in 2 cases，urinary retention in 1 case．No wound infection occurred．The average hospitalization time Was(5．5±2．9)days，and all patients were followed up for 6 months to 2 years without recurrence．Conclusion Local block anesthesia is safe and effective for inguinal hernia tension—free repair in the elderly patients，while the watchful monitor is required． 【Key words】Hernia，inguinal；Hemiorrhaphy；Anesthesia，local；Aged 随着社会老龄化进程的加快，老年腹股沟疝患者逐年增多，目前无张力疝修补术是治疗老年腹股沟疝最有效的方。如何尽可能降低手术风险，更为便捷、高效地完成手术，仍是广大医务工作者不断地努力探索的目标。在此，在局部神经阻滞麻醉下对68例老年腹股沟疝患者进行无张力疝修补术，临床效果满意，现报道如下。 一、资料与方法 1．一般资料：选取2015年12月至