局麻无张力疝修补术在老年并发前列腺增生症腹股沟疝中的应用

目的探讨并发前列腺增生症的腹股沟疝老年病人局部麻醉下行腹股沟无张力疝修补术的优势。方法局麻下对67例并发前列腺增生症的腹股沟疝老年病人行无张力疝修补术，对麻醉满意度、手术时间、术后切口疼痛、术后下床活动时间、并发症、住院天数、住院费用和术后有无复发进行调查。结果手术操作中轻微疼痛15例，麻醉满意52例；手术时间35～50min，平均40min；术后2～8h后可下床活动。无切口感染发生，无急性尿潴留发生，出现阴囊积液6例，腹股沟异物感5例，手术部位浆液肿3例。平均住院3．5d出院。平均住院费用为3986元。随访63例，随访至12个月，无复发病例。结论并发前列腺增生症的腹股沟疝老年病人采用局麻下无张力疝修补术治疗，术后并发症少，住院时间短，花费少，值得推广。

TENSION-FREE INGUINAL HERNIORRHAPHY UNDER LOCAL ANESTHESIA FOR AGED PATIENTS COMPLICATED BY HYPERPLASIA OF PROSTATE

Objective To explore the advantages of tension-free inguinal herniorrhaphy （TFIH） under local anesthesia for aged patients complicated by benign prostatic hyperplasia （BPH）. Methods TFIH was performed in 67 patients who were complicated by BPH. The items of investigation were as follows： satisfaction with anesthesia, operation time, pain of incision after surgery, postoperative out-of-bed activity, complications, hospital day, cost of hospitalization, and yes-or-no recurrence. Results Little pain was recorded in 15 patients, 52 satisfied with the anesthesia; the operation time （mean） was 35-50 rain （40 min） ; out- of-bed activity started 2-8 h, postoperatively. No incision infection and no acute urinary retention were recorded. Scrota/ hydro- cele was noted in six cases, foreign body sensation in groin in five, and three had serous fluid swelling at the site of surgery. An average hospital stay was 3.5 d with average expenses of 3 986 yuan. Sixty-three patients were followed up for 12 months, no re- currence was recorded. Conclusion For the aged BPH patients under local anesthesia with few postoperative complications, short with inguinal hernia, the tension-free hernia repair can be done hospital stay and lest expense, which is worth popularization.