局部麻醉下行日间腹股沟疝无张力修补术的临床应用

Day-surgery of inguinal hernia repair under local anesthesia in adult patients

目的探讨局部麻醉下行日间腹股沟疝修补术的安全性以及有效性。方法回顾性分析2011年3月至2014年3月,汝州市第一人民医院连续观察在局部麻醉下行日间腹股沟疝无张力修补术的516例患者的临床资料,分析住院时间、术后并发症、住院费用等情况。结果 516例患者手术时间35-72 min,中位时间45.4 min,所有患者顺利完成手术。489例（94.8%）满足日间手术要求,顺利于术后24 h内出院,20例（3.9%）于术后48 h出院,7例患者留院观察3-7 d出院,平均花费3 832元。术后并发症的发生率为6.9%（35/504）,其中血肿10例,阴囊水肿15例,发热3例,尿潴留2例,慢性疼痛/麻木5例。术后4 h的VAS评分为（3.1±1.4）分,术后3 d（1.6±0.6）分。结论局部麻醉下的日间腹股沟疝修补术近期疗效是安全有效的,能明显缩短住院时间、降低住院费用,值得推广。

Objective To assess the safety and efficacy of the local anesthesia procedure in daysurgery inguinal hernioplasty practice. Methods A total of 516 inguinal herniorrhaphy were performed between March 2011 and March 2014. Hospitalization stay,costs and complications were evaluated. Results The operating time is 35 to 72 minutes,and mean of 45. 4 minutes. All operations were completed successfully. 489 patients（ 94. 8%） were discharged on the day of their operation,and 20 patients were discharged in 48 hours after the surgery. Seven patients required additional observation（ 3 to 7 days） because of fever or cellulitis. The postoperative complications rate was approximately 6. 9%（ 35 /504 cases）,including hematoma（ 10 cases）,scrotal swelling（ 15 cases）,fever（ 3 cases）,urinary retention（ 2cases）,and chronic pain / numbness（ 5 cases）. The VAS scores at 4 hours and in 3 days after the operation were（ 3. 1 ± 1. 4） and（ 1. 6 ± 0. 6）,respectively. Conclusion It suggests that day-surgery of hernia repair under local anesthesiais safe and effective,and yields excellent early outcomes. Also,it can significantly shorten the time of hospitalization,reduce medicalcosts.