Lichtenstein疝修补术治疗长期使用抗凝药物的老年腹股沟疝病人的临床观察

目的 研究李金斯坦无张力疝修补术治疗长期使用抗凝药物的老年腹股沟疝病人的临床疗效。方法 回顾性分析2015年1月至2017年12月间，中山大学附属第八医院胃肠外科使用Lichtenstein无张力疝修补术在局部浸润麻醉下治疗108例长期使用抗凝药物的老年男性病人的临床资料。结果 本组病人围手术期无死亡，无严重并发症出现，手术时间50~105 min，术中出血5~20 mL，血氧饱和度均正常，术后病人给予普食，未出现尿潴留。有8例患者出现血清肿，其中5例予以抽吸后好转，无切口感染。术中血压上升有12例，心率增快有10例。术中出现疼痛共16例。术后 6 h、12 h、24 h的疼痛评分（视觉模拟评分法）分在3分以下。术后慢性疼痛、感觉异常有2例。结论 长期使用抗凝药物的老年腹股沟病人局麻下行李金斯坦无张力疝修补术，安全有效，并发症少，病人术后恢复快。

Effect of withdrawal of antiplatelet and anticoagulation therapy for elderly inguinal hernia patients undergoing Lichtenstein tension-free hernia repair

【Abstract】 Objective To observe the clinical efficacy of Lichtenstein tension-free hernioplasty in the treatment of elderly inguinal hernia patients who withdrawing anticoagulants and antiplatelet. Methods A retrospective analysis was made of the clinical data of 108 elderly male patients with long-term use of anticoagulants treated by Lichtenstein tension-free hernioplasty in gastrointestinal surgery of the Eight Affiliated Hospital of Sun Yat-sen University from January 2015 to December 2017 under local infiltration anesthesia. Results There was no death and no serious complications during the perioperative period. The operation lasted 50 to 105 min with bleeding of 5 to 20 ml and normal oxygen saturation. After operation, patients were given general diet and no urinary retention occurred. There were 8 patients with seroma, which improved after aspiration, and no incision infection. During the operation, blood pressure increased in 12 cases and heart rate increased in 10 cases. There were 16 cases of pain during operation. The pain score (visual analogue score) at 6, 12 and 24 hours after operation was below 3. There were 2 cases of chronic pain and abnormal sensation after operation. Conclusion For elderly patients at high risk of thromboembolism this may be safe way to decrease bleeding risk with no anticoagulants and antiplatelets when undergoing Lichtenstein tension-free hernioplasty.