CAJ | 학술논문

目的：探讨腹股沟疝无张力修补术更适宜的麻醉方式。方法随机选取2011年10月至2013年5月医院收治的单侧初发腹股沟疝患者120例，随机分为两组。A 组为硬膜外麻醉组，B 组为瑞芬太尼、丙泊酚、利多卡因复合麻醉组，手术方式均采用充填式无张力疝修补术。结果两组患者均顺利完成手术。B 组患者在手术时间、术后下床时间、住院时间、住院费用、术后满意度、术后尿潴留发生情况等方面均优于 A 组（ P ＜0.05）。两组患者术后切口感染、皮下血肿、头痛、发生率情况比较无明显差异（ P ＞0.05），但 B 组患者术中记忆情况明显优于 A 组（ P ＜0.05）。结论瑞芬太尼、丙泊酚、利多卡因复合液能安全应用于患者清醒状态下实施无张力腹股沟疝修补术，具有良好的临床推广价值。
목적：탐토복고구산무장력수보술경괄의적마취방식。방법수궤선취2011년10월지2013년5월의원수치적단측초발복고구산환자120례，수궤분위량조。A 조위경막외마취조，B 조위서분태니、병박분、리다잡인복합마취조，수술방식균채용충전식무장력산수보술。결과량조환자균순리완성수술。B 조환자재수술시간、술후하상시간、주원시간、주원비용、술후만의도、술후뇨저류발생정황등방면균우우 A 조（ P ＜0.05）。량조환자술후절구감염、피하혈종、두통、발생솔정황비교무명현차이（ P ＞0.05），단 B 조환자술중기억정황명현우우 A 조（ P ＜0.05）。결론서분태니、병박분、리다잡인복합액능안전응용우환자청성상태하실시무장력복고구산수보술，구유량호적림상추엄개치。
Objective To explore the more suitable way of anesthesia in tension - free inguinal hernia repair. Methods 120 cases of u-nilateral initial inguinal hernia treated in our hospital from October 2011 to May 2013 were randomly selected and divided into two groups. The group A received the epidural anesthesia,while the group B adopted the combined anesthesia of remifentanyl,propofol and lidocaine. The operation mode was the filling tension - free hernia repair. The intraoperative and postoperative conditions and complica-tions were compared between the two groups. Results Two groups successfully completed the surgery. The group B was superior to the group A in the aspects of the operative time,time in postoperatively getting out of bed,hospitalization time,hospitalization cost,postoper-ative satisfaction and the postoperative uroschesis ( P < 0. 05). The occurrence rates of postoperative incision infection,subcutaneous hematoma and headache had no obviously difference between the two groups( P > 0. 05). But the intraoperative memory status in the group B was superior to that in the group A( P < 0. 05). Conclusion The compound liquid of remifentanil,propofol and lidocaine can be safely applied in the tension - free inguinal hernia repair under awakening state and has a good clinical promotion value.