不同麻醉方式行急诊嵌顿性腹外疝修补术临床疗效比较研究  

Comparative study on clinical efficacy of different anesthesia methods in emergency incarcerated abdominal external hernia repair

作　　者：余河斌 徐叶亮 YU Hebin;XU Yeliang(Department of General surgery,Zhongxian People's Hospital of Chongqing,Chongqing 404399,China;Department of Vascular Surgery,Xuancheng People′s Hospital,Xuancheng,Anhui 242000,China)

机构地区：[1]忠县人民医院普外科,重庆忠县404399 [2]宣城市人民医院血管外科,安徽宣城242000

出　　处：《现代医药卫生》2024年第22期3844-3848,3854,共6页Journal of Modern Medicine & Health

摘　　要：目的对比分析局部麻醉与全身麻醉行急诊嵌顿性腹外疝修补术的临床效果疗效。方法回顾性分析2018年1月至2023年1月重庆市忠县人民医院收治的65例嵌顿性腹外疝患者的临床资料,以不同麻醉方式分为局部麻醉组(24例)和全身麻醉组(41例)。对比分析2组患者的基础资料、术中资料、术后并发症、随访资料的差异。结果与全身麻醉组比较,局部麻醉组患者年龄更大,基础疾病更多,应用抗栓药物比例,以及美国麻醉医师协会、纽约心脏病协会分级均更高,术后下床时间、住院时间均更短,尿潴留、恶心/呕吐并发症发生率均更低,术后疼痛、阿片类药物使用率更高,差异均有统计学意义(P<0.05)。结论对高龄合并基础疾病较多的急诊嵌顿性腹外疝患者,局部麻醉是安全、有效的,有利于患者的术后恢复,值得临床推广应用。Objective To compare the clinical effect of local anesthesia and general anesthesia in emergency incarcerated external abdominal hernia repair.Methods The clinical data of 65 patients with incarcerated abdominal external hernia treated in Zhongxian People's Hospital of Chongqing from January 2018 to January 2023 were retrospectively analyzed.They were divided into the local anesthesia group(24 cases)and the general anesthesia group(41 cases)according to different anesthesia methods.The differences of basic data,operative materials,postoperative complications and follow-up data between the two groups were compared and analyzed.Results The patients in the local anesthesia group were older,had more underlying diseases,higher proportion of antithrombotic drugs,higher classification of the American Society of Anesthesiologists and the New York Heart Association,shorter postoperative ambulation time and hospitalization time,lower incidence of urinary retention,nausea/vomiting complications,postoperative pain and opioid use rate were significantly higher than those in the general anesthesia group.The differences were statistically significant(P<0.05).Conclusion The local anesthesia is safe and effective for elderly patients with emergency incarcerated abdominal external hernia with more underlying diseases,which is beneficial to the postoperative recovery of patients and worthy of clinical application and promotion.

关 键 词：嵌顿疝 腹外疝 局部麻醉 全身麻醉 疝修补术 并发症 

分 类 号：R656.2[医药卫生—外科学] R614[医药卫生—临床医学]