摘要
目的探讨局麻下开放性前入路腹膜前腹股沟疝修补术的技术要点和临床疗效。方法回顾性分析2007年1月至2009年8月应用通用(Star-WNTM)星形非编织补片、巴德Modified Kugel补片行开放性前入路腹膜前修补治疗腹股沟疝176例次患者的临床资料。对患者手术前合并症、手术时间、手术方式、术后镇痛药应用、术后并发症、术后住院天数以及随访情况进行综合分析。结果手术时间30～110min(平均50 min),术后4～24 h下床活动(平均6 h),术后2～6 d恢复日常活动(平均4 d),术后2～8 d出院(平均4 d)。无1例出现术后尿潴留。切口疼痛轻,术后均未用止痛治疗。术后无1例皮下血肿,3例出现阴囊水肿,无切口感染。所有患者均痊愈出院。随访3～18个月,其中1例出现腹股沟区慢性疼痛,无局部异物感,无复发。结论局麻下应用通用(Star-WNTM)星形非编织补片、巴德Modified Kugel补片实施开放性前入路腹膜前腹股沟疝无张力修补术具有简单、有效、安全、微创、无张力、患者恢复快、并发症少、复发率低等优点,尤其适合于合并多种慢性疾病的老年患者,为腹股沟疝患者提供了一种理想的治疗方法。
Objective To assess the result and technical key points of open anterior preperitonal inguinal hernia repair under local anesthesia. Methods Retrospetively analyses of the clinical data of 176 cases who suffered inguinal hernia repair by open preperitonal anterior approach from January 2007 to August 2009. Preoperative complication, operation time, operative methods, postoperative pain, hospital time and the results of follow - up were analyzed. Results The mean operation time were 50 min （ rang 30 to 110）. The mean time of leaving a sickbed were 6 hours （rang 4 to 24）. The mean resuming regular activities time were 4 days （ rang 2 to 6）. The mean time of postoperative hospital stay were 4 days （ rang 2 to 8 ）. No pa- tient was found urinary retention, subcutaneous hematoma and infection of incisional wound in postoperative. All incisional pain were mild without pain relief treatment. Hydrocele was found in 3 patients. All patients were recovered. During the follow - up （3 to 18 months）, recurrence was not found, and there was one case of local chronic pain. Conclusions The method of open anterior preperitonal inguinal hernia repair under local anesthesia is simple, effective, safe, minimally invasive, and it is easy to recover with few of complica- tions and low recurrece rate. And it is especially suitable for old patients with various chronic diseases. It is an ideal treatment for patients with inguinal hernia.
出处
《中华疝和腹壁外科杂志（电子版）》
2010年第1期40-42,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
腹股沟
局麻
局部
无张力疝修补术
腹膜前
Hernia, inguinal
Anaesthesia local
Tension-free herniorrhaphy
Preperitoneal.
