硬膜外麻醉和全身麻醉对精索静脉曲张患者术后复发的影响

The clinical research of different anesthesia methods on postoperative recurrence of varicocele patients

目的探讨硬膜外麻醉和全身麻醉对精索静脉曲张患者行腹膜后精索静脉高位结扎术后复发的影响。方法回顾性分析2015年9月至2018年12月该院收治的45例精索静脉曲张行腹膜后精索静脉高位结扎术手术患者的临床资料,根据不同麻醉方式分为硬膜外麻醉组(23例)和全身麻醉组(22例)。比较两组患者术后6、12个月复发情况,以及手术时间、术后12 h疼痛视觉模拟评分、住院时间、并发症发生情况等。结果两组患者住院时间、手术时间、并发症发生率比较,差异均无统计学意义(P>0.05)。但与硬膜外麻醉组比较,全身麻醉组患者术后12 h疼痛视觉模拟评分、术后复发率均更低,差异均有统计学意义(P<0.05)。结论硬膜外麻醉和全身麻醉均可有效支持腹膜后精索静脉高位结扎术的开展,但全身麻醉行腹膜后精索静脉高位结扎术后复发率更低,患者手术体验更佳。

Objective To investigate the effects of two different anesthesia methods,epidural anesthesia and general anesthesia,on the recurrence rate of patients with varicocele undergoing retroperitoneal high ligation of the spermatic vein.Methods Retrospective analysis.The 45 patients with varicocele undergoing retroperitoneal high ligation of the spermatic vein were enrolled from September 2015 to December 2018.They were divided into epidural anesthesia group and general anesthesia group according to the choice of anesthesia method.Postoperative recurrence(6,12 months),operation time,postoperative pain score,hospital stay and other complications in the two groups.Results There was no significant difference between the two groups of patients in hospitalization time,operation time,and the incidence of complications such as scrotal edema,orchitis,and hydrocele(P>0.05).However,in the general anesthesia group,the recurrence rate of varicocele patients was lower than that in the epidural anesthesia group(P<0.05),and the postoperative pain score was lower(P<0.05).Conclusion Both epidural anesthesia and general anesthesia can effectively support the development of retroperitoneal high ligation of the spermatic vein,but general anesthesia with retroperitoneal high ligation of the spermatic vein has a lower postoperative recurrence rate and better surgical experience.