局部神经阻滞麻醉在老年腹股沟疝患者无张力修补术中的应用

Clinical Experience on Local Nerve Blockade Anaesthesia for Tension-free Inguinal Hernia Repairing in the Senile Patients

目的探讨局部神经阻滞麻醉在腹股沟疝无张力修补术中的临床应用。方法对2002年2月至2008年6月间收治的3 257例老年腹股沟疝患者在局部神经阻滞麻醉下行腹股沟疝无张力修补术,分析手术时间、术中麻醉效果、术后合并症、手术费用、平均住院日和术后随访情况。结果手术时间为18～50 min,平均28 min,术中麻醉效果好,术后未出现尿潴留。有36例患者出现阴囊浆液肿和血肿,1例出现切口感染,28例出现切口下血肿,5例出现术后慢性疼痛。患者平均住院日为2.9 d,平均手术费用为4 267元。平均随访48个月,有4例患者复发,异物感不明显。结论局部神经阻滞麻醉下腹股沟疝无张力修补术安全可靠,麻醉效果好,手术适应证广,术后合并症少,恢复快,住院时间短且具有良好的效价比,特别适用于老年患者。

Objective To evaluate the curative effect of local nerve blockade anaesthesia for tension-free inguinal hernia repairing in senile patients. Methods 3 257 senile patients with tension-free hernioplasty under local nerve blockade anaesthesia from Feb 2002 to Jun 2008 in our center were analyzed. Results The operative time was 18 to 50 minutes at average time 28 minutes. M1 patients had good anaesthetic condition and no urinary retention, except one case with infective wound, 36 cases with scrotal hydrocles and 5 cases with chronic pain. The average stay in hospital was 2.9 days, and the average cost was 4 267 yuan（RMB）. 4 cases had recurrence and no one had the feeling of foreign body follow-up in an average of 48 months. Conclusion The open groin tension-free hernioplasty under local nerve blockade anaesthesia is a safe and credible operation procedure.