局麻下腹腔镜完全腹膜外疝修补术的围手术期护理

Perioperative nursing of totally extraperitoneal laparoscopic hernia repair under local anesthesia

目的总结局麻下腹腔镜完全腹膜外疝修补术（TEP）的围手术期护理经验。方法对2009年1月～2010年1月采用局麻完成的26例（28例次）TEP患者进行围手术期护理观察。结果所有患者均治愈，术后平均住院2．4d，主要并发症为皮下气肿2例，术后未出现血肿／血清肿、持续性神经性疼痛、切口感染、补片感染及尿潴留，术后平均随访8个月未见复发病例。结论局麻下腹腔镜完全腹膜外疝修补术安全可靠，术后疼痛轻，恢复更快，术后恢复体力活动早，可以明显降低手术费用，易被患者及外科医生接受，明显减少了护理工作量，但心理护理非常重要。

Objective To summarize perioperative nursing experience of totally extraperitoneal laparoscopic hernia repair under local anesthesia. Methods The effect of perioperative nursing on 26 cases with inguinal hernia treated by totally extraperitoneal laparoscopic hernia repair under local anesthesia from January 2009 to January 2010 was observed. Results All cases were oper- ated successfully. The average postoperative stay was 2.4 （ 1 - 4） days. Most complications included 2 cases of subcutancous emphysema. There were no complications of hematoma/seroma, persistent nervous pain, wound infection, mesh infection after operations, and urinary retentio. All patients were followed up for 8 （3--15） months, and there were no recurrence. Conclusion Totally extraperitoneal laparoscopic hernia repair under local anesthesia is safe and effective for inguinal hernia with advantages of less pain, quick recovery and, lower operation cost, which can be easily accepted by both patients and surgeons. It can obviously reduce the nursing workload, but mental nursing is also very important.