摘要
目的观察局麻无张力疝修补术(Lichtenstein)与腹腔镜经腹腹膜前疝修补术(TAPP)在腹股沟疝手术治疗中的效果。方法回顾性分析局部麻醉下行Lichtenstein术及TAPP术患者的临床资料,其中局麻下Lichtenstein术患者36例为A组,TAPP术患者40例为B组。对比分析2组患者手术时间、术后下床活动时间、术后8 h及48 h的疼痛评分、住院时间、住院费用及术后并发症发生情况,比较2组的疗效。结果A组患者手术时间更短、术后下床活动更早、住院时间更短、住院费用更少,差异具有统计学意义(P<0.05);术后8 h疼痛评分2组间比较差异无统计学意义(P>0.05);但B组患者术后48 h疼痛评分优于A组(P<0.05)。2组患者术后随访1年均无复发,A组术后切口积液或感染的发生率高于B组(P<0.05),B组术后更易出现尿潴留、腹胀、头晕或恶心、呕吐不适(P<0.05)。结论局麻下无张力疝修补术安全有效,术后并发症发生率较低,且更适合心肺功能不良的老年患者,值得在临床实践中推广应用。
Objective To observe the effect of tension-free herniorrhaphy(Lichtenstein)nder local anesthesia and laparoscopic trans-abdominal preperitoneal hernia repair(TAPP)in the treatment of inguinal hernia.Methods A retrospective analysis was conducted on 76 patients with tension-free hernia repair,all the patients were divided into group A(Lichtenstein under local anesthesia group,n=36)and group B(TAPP group,n=40),and all the surgeries were performed by the same group of surgeons.The operation time,postoperative activity time of getting out of bed,pain score at 8 h and 48 h after surgery,hospitalization time,hospitalization costs and postoperative complications between group A and group B were compared.Results The operation time of group A was shorter than that of group B,the postoperative activity was earlier than that of group B,the hospitalization time was shorter than that of group B,and the hospitalization cost was lower than that of group B.The difference between the two groups was statistically significant(P<0.05).The incidence of postoperative incision effusion or infection in group A was higher than that in group B(P<0.05).However,the pain score at 48 h after surgery of group B was better than that of group A(P<0.05).There was no recurrence during the follow-up period of 1 year after operation.There was no difference in the incidence of scrotal emphysema and scrotal serous edema between the two groups(P>0.05),the incidence of postoperative incision effusion or infection in group A was higher than that in group B(P<0.05),but group B was more prone to urinary retention,abdominal distension,dizziness or nausea,and vomiting(P<0.05).Conclusions Tension-free herniorrhaphy under local anesthesia is safe and effective,it has a lower incidence of postoperative complications,and it is more suitable for the elderly patients with cardiopulmonary dysfunction.
作者
赵勇
狄华明
胡雪莲
虎晓军
马建文
ZHAO Yong;DI Huaming;HU Xuelian;HU Xiaojun;MA Jianwen(Department of General Surgery,Ningxia Hui Autonomous Region People’s Hospital,Yinchuan 750002,China;Department of Critical Care Medicine,Ningxia Hui Autonomous Region People’s Hospital,Yinchuan 750002,China)
出处
《宁夏医学杂志》
CAS
2020年第2期129-131,共3页
Ningxia Medical Journal
关键词
腹股沟疝
无张力疝修补术
局部麻醉
Inguinal hernia
Tension-free herniorrhaphy
Local anesthesia
