局部麻醉下李金斯坦平片改良修补腹股沟疝的研究

Study on Lichtenstein improvement repair of inguinal hernia under local anesthesia

目的回顾性分析局部麻醉下应用李金斯坦（Lichtenstein）平片改良修补腹股沟疝的临床效果。方法以2%盐酸利多卡因15 ml＋2.5%盐酸布比卡因15 ml＋0.9%生理盐水30 ml＋肾上腺素0.3 mg混合总量约60 ml,手术切口标记线上每距离1~1.5 cm处作分点局部浸润麻醉。麻醉达成后处理好疝囊,再将李金斯坦平片置入加强精索后壁或增强股管张力,并观察本院经李金斯坦平片改良修补腹股沟疝和其他手术方式Rutkow、Kugel、M-Kugel、PHS、TEP在住院时间、费用、术后复发、术后慢性疼痛等指标方面的变化。结果从本院在腹股沟疝修补术中的手术方式对比中,局麻下李金斯坦平片改良修补术后住院时间和费用明显低于其他手术方式（P〈0.05）,术后复发及慢性疼痛均较低,无显著差异。结论局麻下李金斯坦平片改良修补术式能同时覆盖腹股沟区所有疝突出的部位,且住院时间短、费用较低、术后疼痛轻、复发概率低等优点,在基础医院即可实施,值得临床推广。

Objective To Study Lichtenstein improvement repair of inguinal hernia under local anesthesia. Methods With 2% lidocaine hydrochloride 15ml and 2.5% bupivacaine hydrochloride 15ml and 0.9% saline 30ml and 0.3 mg epinephrine were mixed to 60ml, the line of surgical incision marking distance for each 1 - 1.5cm taken as a injection point in local infiltration anesthesia. When anesthesia succeeded, continued to deal with the hernia sac, then using the Lichtenstein mesh implantation to strengthen posterior wall of spermatie cord or enhance the tension, of femoral canal, and the Lichtenstein mesh improvement repair of inguinal hernia and other surgery methods, including Rutkow, Kugel, M-Kugel, PHS, and TEP. To observe the index, changes in hospitalization time, cost, postoperative recurrence and postoperative chronic pain. Results In our hospital in inguinal hernia repair operation method contrast, the improvement repair used Lichtenstein mesh under local anesthesia, hospitalization time and cost was lower than that of other surgical methods （P〈0. 05）, postoperative recurrence and chronic pain were low, there was no significant difference. Conclusions Lichtenstein mesh of improvement repair under local anesthesia can cover the site of all the hernia in the groin region, which has the advantages of shorter hospital stay, lower cost, less postoperative pain and low recurrence probability. In the basic hospital can be implemented, it is worthy of clinical promotion.