局部神经阻滞麻醉下的腹膜前腹股沟无张力疝修补术

目的探讨局部神经阻滞麻醉下的腹膜前无张力修补在腹股沟区疝中的应用。方法采用美国强生公司生产的普理灵疝装置、美国巴德公司生产的可固(Kugel)补片及网塞补片、德国贝朗公司或美国艾瑞公司生产的大号自主成型补片和北京天助畅运公司的善愈补片作为疝修补材料,对2002年2月至2008年1月6年间收治的3126例腹股沟区疝患者进行局部神阻滞麻醉下的腹膜前腹股沟无张力疝修补,观察手术时间,手术后疼痛程度,术后各种并发症的发生情况、手术费用、平均住院日和近期随访情况。结果手术时间平均25分钟,术后疼痛轻微,未出现尿潴留,阴囊浆液肿56例。本组患者围手术期死亡3例,切口感染2例,切口下血肿18例,术后慢性疼痛6例,平均住院日3天,平均手术费用4644元。平均随访69个月,复发10例,所有患者异物感均不明显。结论局部神经阻滞麻醉下的腹膜前腹股沟无张力疝修补是一种安全、可靠的手术方式,尤其适用于疝环或腹横筋膜缺损较大的腹股沟疝老年患者。

Open Preperitoneal Groin tension-free hernioplasty under local nerve blockade anaesthesia

Objective To evaluate the application of open preperitoneal groin tension-free hernioplasty under local nerve blockade anaesthesia. Methods Three thousand one hundred twenty six patients with preperitoneal groin tension-free hernioplasty under local nerve blockade anaesthesia from Feb 2002 to Jan 2008 in our center were analyzed to observe operative time, degree of pain. Results The operative time was 15 to 60 minutes, average time was 25 minutes. All patients had slight wound pain after operation. Three cases died during the stay in hospital, Two cases had the wound infection, no one had urinary retention, the Scrotal hydroceles were 56 cases, the chronic pain was 6 cases. the average stay in hospital were 3 days, the average cost was 4644 Yuan (RMB), 10 cases had recurrence and no one had the feeling of foreign body follow-up average 69 months. Conclusions The open preperitoneal groin tension-free hernioplasty under local nerve blockade anaesthesia was a safe and credible operative method, especially for the old patients with inguinal hernia who has large hernia ring or defect of transversalis fascia (TF).