CAJ | 학술논문

目的：探讨局部麻醉下充填式无张力修补术治疗高龄患者腹股沟疝的安全性及临床效果。方法回顾性分析2008年1月至2013年9月，河南省职工医院在局部麻醉下行充填式无张力修补术治疗高龄（＞80岁）腹股沟疝37例患者的临床资料，记录手术时间、术中出血量、并发症及复发情况。结果37例患者均在局部麻醉下完成疝环充填式无张力修补术，辅以静脉基础麻醉5例。平均手术时间45 min，平均术中出血量7．6 ml，术后出现近期并发症7例（18．92％），术后伤口周围红肿预防应用抗生素5例。上述术后并发症均经相应处理痊愈，无死亡，术后随访时间3～12个月，无复发。结论局部麻醉下充填式无张力疝修补术操作简便、安全、不良反应轻，尤其对不能耐受硬外、椎管内及全身麻醉的高龄患者是一种安全、理想的选择。
목적：탐토국부마취하충전식무장력수보술치료고령환자복고구산적안전성급림상효과。방법회고성분석2008년1월지2013년9월，하남성직공의원재국부마취하행충전식무장력수보술치료고령（＞80세）복고구산37례환자적림상자료，기록수술시간、술중출혈량、병발증급복발정황。결과37례환자균재국부마취하완성산배충전식무장력수보술，보이정맥기출마취5례。평균수술시간45 min，평균술중출혈량7．6 ml，술후출현근기병발증7례（18．92％），술후상구주위홍종예방응용항생소5례。상술술후병발증균경상응처리전유，무사망，술후수방시간3～12개월，무복발。결론국부마취하충전식무장력산수보술조작간편、안전、불량반응경，우기대불능내수경외、추관내급전신마취적고령환자시일충안전、이상적선택。
Objective To investigate the safety and clinical effect of mesh plug tension-free herniorrhaphy under local anesthesia for aged patients.Methods The clinical data of 37 patients aged over 80,who were received the operation of mesh plug tension-free herniorrhaphy under local anesthesia in the Henan Zhigong Hospital from January 2008 to September 201 3,were analyzed retrospectively.Data collected included:operation time,intraoperative blood loss,the cases of complication and recurrence.Results All of the 37 cases were performed the operation of mesh plug tension-free herniorrhaphy under local anesthesia. Basic anesthesia by intravenous was implemented in 5 cases.The procedure was completed in a mean of 45 minutes with the average blood loss of 7.6 ml.Postoperative early complications were occurred in 7 cases (1 8.92%).Antibiotics were used in 5 cases because of swelling around the wound after surgery.These complications were cured by appropriate treatment.No deaths and no recurrence through 3 to 1 2 months of postoperative follow-up.Conclusions The operation of mesh plug tension-free herniorrhaphy under local anesthesia is simple,safe,less adverse reactions.It is a safe,ideal choice especially for aged patients who could not tolerate epidural,spinal and general anesthesia.