局部神经阻滞麻醉下无张力疝修补术在肝硬化腹水合并腹股沟疝患者中的应用  

Application of pre-peritoneal tension-free hernia repair under local anesthesia in inguinal hernia patients complicated with cirrhotic ascites

作　　者：张传宝[1] 张敬坡[1] 冯雷[1] 秦静[1] 张海涛[1] 孙江义[1] 

机构地区：[1]河北省石家庄市第三医院普外二科,050011

出　　处：《中华疝和腹壁外科杂志（电子版）》2016年第6期414-416,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的 探讨局部神经阻滞麻醉下无张力疝修补术在肝硬化腹水合并腹股沟疝患者中应用的安全性和可靠性。方法 回顾性分析2013年1月至2016年1月,石家庄市第三医院收治肝硬化腹水合并腹股沟疝患者29例的临床资料,患者均行腹膜前无张力疝修补术。结果 本组29例疝修补手术均顺利完成,腹股沟疝单侧手术平均（42±4）min,术后切口感染2例,阴囊积液4例,切口疼痛和异物感3例,轻度肝性脑病1例,以上并发症经积极对症治疗后治愈。未出现上消化道出血、肝功能衰竭等并发症,无死亡患者。29例患者通过电话及门诊随访,随访时间为4-36个月,平均18.5个月,随访期内无患侧疝复发,但术后出现2例另一侧腹股沟疝。结论 局麻下腹膜前无张力疝修补术对于肝硬化腹水合并腹股沟疝患者是一种安全有效的手术方法,值得推广。Objective To discuss the safety and reliability of pre-peritoneal tension-free herniorrhaphy under local anesthesia in inguinal hernia patients complicated with ascites due to cirrhosis. Methods From January 2013 to January 2016,29 patients with cirrhotic ascites and inguinal hernia who received pre-peritoneal tension-free hernia repair in the Third Hospital of Shijiazhuang were retrospectively analyzed. Results Surgery was successfully performed under local anesthesia in all patients and the mean operation time was （42 ± 4） minutes. There were 2 cases of postoperative wound infection, 4 cases of scrotal hydrocele. Incisional pain and foreign body sensation occurred in 3 cases and mild hepatic encephalopathy in 1 case. The above complications were cured after symptomatic treatment. No serious complications was noted, such as upper gastrointestinal bleeding, liver failure and death. The postoperative follow-up was 4 to 36 months （average of 18.5 months ）. There was no recurrence on the operative side. but 2 cases of recurrence occurred on the notloperative site. Conclusion The pre-peritoneal tension-free herniorrhaphy under local anesthesia for patients complicated with cirrhotic ascites is safe and effective.

关 键 词：疝 腹股沟 疝修补术 肝硬化 腹水 

分 类 号：R656.21[医药卫生—外科学]