CAJ | 학술논문

目的：探讨与传统利多卡因局部麻醉相比利多卡因加用罗哌卡因在腹股沟无张力疝修补术中的优势。方法回顾性分析2012年1月至2013年12月收治的腹股沟疝患者172例，随机分为接受罗哌卡因联合利多卡因局部麻醉（试验组，88例）和利多卡因局部麻醉（对照组，84例），均行腹股沟疝无张力修补术（预成型网塞加补片修补腹股沟管后壁）。采用SPSS 17．0统计软件包进行分析，比较两组患者手术时间、术后止痛持续时间、离床活动时间、出院时间等采用t检验；术后应用止痛药物情况和患者对麻醉满意情况，采用χ2检验， P＜0．05为差异有统计学意义。结果手术时间：试验组平均（41±8） min，对照组（43±7） min，两组比较差异无统计学意义。试验组术后止痛持续时间平均（7．4±1．6） h，对照组（4．8±1．8） h （t＝10．023， P＜0．001）；术后24 h试验组18例患者使用止痛药物，对照组有31例因疼痛使用止痛药物镇痛（χ2＝5．709， P＝0．017）；离床活动时间：试验组患者平均（4．6±0．8） h，对照组（6．7±1．4） h （t＝12．147， P＜0．001）；平均出院时间试验组（2．7±0．4） d，对照组（3．6±0．5） d （t＝13．065， P＜0．001）；对疼痛满意情况：试验组74例，对照组57例（χ2＝6．238， P＝0．013），以上两组患者比较差异均有统计学意义。结论加用罗哌卡因联合利多卡因局部麻醉行腹股沟疝无张力修补术较单纯利多卡因麻醉效果更佳，术后疼痛减轻，且恢复快，并发症少，费用低，患者满意度高，适合广泛应用。
목적：탐토여전통리다잡인국부마취상비리다잡인가용라고잡인재복고구무장력산수보술중적우세。방법회고성분석2012년1월지2013년12월수치적복고구산환자172례，수궤분위접수라고잡인연합리다잡인국부마취（시험조，88례）화리다잡인국부마취（대조조，84례），균행복고구산무장력수보술（예성형망새가보편수보복고구관후벽）。채용SPSS 17．0통계연건포진행분석，비교량조환자수술시간、술후지통지속시간、리상활동시간、출원시간등채용t검험；술후응용지통약물정황화환자대마취만의정황，채용χ2검험， P＜0．05위차이유통계학의의。결과수술시간：시험조평균（41±8） min，대조조（43±7） min，량조비교차이무통계학의의。시험조술후지통지속시간평균（7．4±1．6） h，대조조（4．8±1．8） h （t＝10．023， P＜0．001）；술후24 h시험조18례환자사용지통약물，대조조유31례인동통사용지통약물진통（χ2＝5．709， P＝0．017）；리상활동시간：시험조환자평균（4．6±0．8） h，대조조（6．7±1．4） h （t＝12．147， P＜0．001）；평균출원시간시험조（2．7±0．4） d，대조조（3．6±0．5） d （t＝13．065， P＜0．001）；대동통만의정황：시험조74례，대조조57례（χ2＝6．238， P＝0．013），이상량조환자비교차이균유통계학의의。결론가용라고잡인연합리다잡인국부마취행복고구산무장력수보술교단순리다잡인마취효과경가，술후동통감경，차회복쾌，병발증소，비용저，환자만의도고，괄합엄범응용。
Objective To investigate the advantages of combined application of lidocaine and ropivacaine in local anesthesia of tension-free inguinal hernia repair.Methods From January 2012 to December 2013, 172 patients with inguinal hernia were randomly divided into 2 groups:88 patients in lidocaine+ropivacaine group (test group) and 84 patients in lidocaine group (control group) , all of whom received tension-free repair . Clinical data were analyzed retrospectively by using SPSS 17.0 software.The operation time, analgesic duration, time to ambulation, hospital stay were compared by using the t test , while postoperative use of analgesic and anesthesia satisfaction of patients were compared by using χ2 test.P <0.05 was considered statistically significant.Results Operation time of the test group was (41 ±8) minutes, which was not significantly shorter than that of the control group [(43 ±7) minutes (t=1.742, P=0.083)].The analgesic duration of the test group was (7.4 ±1.6) hours, which was longer than that of [(4.8 ±1.8) hours] the control group, (t=10.023, P<0.001).There were 18 patients using painkillers in the test group 24 hours after operation, significantly less than 31 patients in the control group (χ2 =5.709, P=0.017).The mean time to ambulation of the test group was (4.6 ±0.8) hours, which was significantly shorter than that of the control group[(6.7 ±1.4) hours (t=12.147, P<0.001)].The mean discharge time of the test group was (2.7 ±0.4) days, which was significantly shorter than that of the control group [(3.6 ±0.5) days (t=13.065, P<0.001)].74 patients were satisfied with the aesthetic effect in the test group, in contrast to 57 patients in the control group of (χ2 =6.238, P=0.013). Conclusion Local anesthesia of ropivacaine combined with lidocaine in tension-free inguinal hernia repair is an effective and safe method with simple operation and minimal invasion , by which patients could gain less pain, faster recovery, and less complications and costs .