局部麻醉下腹膜前间隙修补术在老年腹股沟疝患者中应用体会

目的探讨局部麻醉下腹膜前间隙无张力疝修补术在老年腹股沟疝患者中应用的临床价值。方法回顾性分析2009年1月至2012年9月，聊城市人民医院局部神经阻滞麻醉下治疗老年腹股沟疝患者98例的临床资料。观察麻醉效果、手术时间、住院费用、平均住院日、术后并发症及近期随访情况。结果本组患者均手术顺利完成，麻醉效果满意，单侧平均手术时间（41±10）min，所有患者术后疼痛轻微，术后未使用止痛药物，平均住院费用（4367±215）元，平均住院时间（2．5±0．5）d。全组患者伤口均一期愈合，除2例术后阴囊浆液肿外，其他患者无术后并发症出现，随访6～44个月，无复发、切口感染和慢性疼痛等发生。结论局部神经阻滞麻醉下腹膜前间隙无张力修补老年腹股沟疝是一种理想的手术方式，具有安全、适应证广、创伤小、术后恢复快、并发症少和复发率低等特点。

Preperitoneal tension-free hernioplasty under local anesthesia for elderly patients with inguinal hernia

Objective To investigate the clinical value of preperitoneal tension-free hernioplasty under local anesthesia for elderly patients with inguinal hernia. Methods A total of 98 cases of preperitoneal tension-free hernioplasty were enrolled and analyzed under local anesthesia for the patients with inguinal hernia from January 2009 to September 2012, and the effect of anesthesia, operation time, hospital fees, average length of stay in hospital,postoperative complications and follow-up were evaluated. Results All the patients were repaired successfully under local nerve blockade anesthesia, the unilateral meanly operation time was （41± 10） minutes. All the patients had slight wound pain and no special anesthetic had been used. The meanof unilateral hospital fees was （4 367 ± 215 ）yuan（ RMB）, and the mean for the length of hospitalization was （2.5 ± 0.5 ） days without any postoperative complication excluding two cases suffered with scrotal hematoma. No recurrence and incision infection or chronic pain were observed during a follow-up of 6 to 44 months. Conclusions Preperitoneal tension-free hernioplasty under local anesthesia is a safe and effective with extensive indications, fewer complications and lower recurrence for those patients withinguinal hernia.