武警医学
武警醫學
무경의학
MEDICAL JOURNAL OF THE CHINESE PEOPLE'S ARMED POLICE FORCES
2015年
6期
570-572
,共3页
髂腹股沟神经%髂腹下神经%神经阻滞%老年人%腹股沟斜疝%腰硬联合
髂腹股溝神經%髂腹下神經%神經阻滯%老年人%腹股溝斜疝%腰硬聯閤
가복고구신경%가복하신경%신경조체%노년인%복고구사산%요경연합
ilioinguinal nerve%iliohypogastric nerve%nerve block%aged%indirect inguinal hernia%combined spinal-epidural
目的：对比研究髂腹股沟神经髂腹下神经阻滞及腰硬联合麻醉在老年腹股沟斜疝患者手术中的应用。方法选择行腹股沟斜疝疝囊高位结扎修补术老年患者60例，均为男性，美国麻醉医师协会（ ASA）Ⅱ～Ⅲ级，均为男性。随机将患者分成神经阻滞组与腰硬联合组，每组30例，分别记录入室时、切皮前、切皮后15 min、术毕的心率（ heart rate，HR）、平均动脉压（mean arterial pressure，MAP）、血氧饱和度（saturation of pulse O2，SpO2）变化，记录麻醉操作时间、术后恢复活动时间，麻醉效果评级及术后尿潴溜例数。结果（1）两组各个时间的HR、MAP，SpO2的比较，差异无统计学意义。（2）神经阻滞组操作时间为（3．0±0．8）min，术后恢复活动时间（3．5±1．0）h，而腰硬联合组分别为（14．8±1．0） min和（9．0±1．3）h ，两组比较，差异有统计学意义（ P＜0．05）。（3）麻醉效果评级：神经阻滞组Ⅰ级28例，Ⅱ级2例，腰硬联合组分别为29例和1例，两组差异无统计学意义。（4）术后尿潴留情况：神经阻滞组有2例，腰硬联合组有12例，差异有统计学意义（ P＜0．05）。结论老年患者行腹股沟斜疝疝囊高位结扎修补术，应用髂腹股沟神经髂腹下神经阻滞麻醉操作简单，术后恢复活动时间明显减少，麻醉并发症少，优于腰硬联合麻醉。
目的：對比研究髂腹股溝神經髂腹下神經阻滯及腰硬聯閤痳醉在老年腹股溝斜疝患者手術中的應用。方法選擇行腹股溝斜疝疝囊高位結扎脩補術老年患者60例，均為男性，美國痳醉醫師協會（ ASA）Ⅱ～Ⅲ級，均為男性。隨機將患者分成神經阻滯組與腰硬聯閤組，每組30例，分彆記錄入室時、切皮前、切皮後15 min、術畢的心率（ heart rate，HR）、平均動脈壓（mean arterial pressure，MAP）、血氧飽和度（saturation of pulse O2，SpO2）變化，記錄痳醉操作時間、術後恢複活動時間，痳醉效果評級及術後尿潴霤例數。結果（1）兩組各箇時間的HR、MAP，SpO2的比較，差異無統計學意義。（2）神經阻滯組操作時間為（3．0±0．8）min，術後恢複活動時間（3．5±1．0）h，而腰硬聯閤組分彆為（14．8±1．0） min和（9．0±1．3）h ，兩組比較，差異有統計學意義（ P＜0．05）。（3）痳醉效果評級：神經阻滯組Ⅰ級28例，Ⅱ級2例，腰硬聯閤組分彆為29例和1例，兩組差異無統計學意義。（4）術後尿潴留情況：神經阻滯組有2例，腰硬聯閤組有12例，差異有統計學意義（ P＜0．05）。結論老年患者行腹股溝斜疝疝囊高位結扎脩補術，應用髂腹股溝神經髂腹下神經阻滯痳醉操作簡單，術後恢複活動時間明顯減少，痳醉併髮癥少，優于腰硬聯閤痳醉。
목적：대비연구가복고구신경가복하신경조체급요경연합마취재노년복고구사산환자수술중적응용。방법선택행복고구사산산낭고위결찰수보술노년환자60례，균위남성，미국마취의사협회（ ASA）Ⅱ～Ⅲ급，균위남성。수궤장환자분성신경조체조여요경연합조，매조30례，분별기록입실시、절피전、절피후15 min、술필적심솔（ heart rate，HR）、평균동맥압（mean arterial pressure，MAP）、혈양포화도（saturation of pulse O2，SpO2）변화，기록마취조작시간、술후회복활동시간，마취효과평급급술후뇨저류례수。결과（1）량조각개시간적HR、MAP，SpO2적비교，차이무통계학의의。（2）신경조체조조작시간위（3．0±0．8）min，술후회복활동시간（3．5±1．0）h，이요경연합조분별위（14．8±1．0） min화（9．0±1．3）h ，량조비교，차이유통계학의의（ P＜0．05）。（3）마취효과평급：신경조체조Ⅰ급28례，Ⅱ급2례，요경연합조분별위29례화1례，량조차이무통계학의의。（4）술후뇨저류정황：신경조체조유2례，요경연합조유12례，차이유통계학의의（ P＜0．05）。결론노년환자행복고구사산산낭고위결찰수보술，응용가복고구신경가복하신경조체마취조작간단，술후회복활동시간명현감소，마취병발증소，우우요경연합마취。
Objective To comparatively study the clinical efficacy of elderly indirect inguinal hernia opration under ilioingui-nal-iliohypogastric nerve block and combined spinal-epidural anesthesia.Methods This study included sixty ASAⅡ-Ⅲelderly male patients, undergoing high ligation of hernial sac and indirect inguinal hernia repair.The patients were randomly divided into two groups:group of ilioinguinal-iliohypogastric nerve block and group of combined spinal-epidural anesthesia.HR(heart rate), MAP ( mean arterial pressure) and SpO2 were measured at 4 time points, entering the operating room, before skin incision, 15 min after inci-sion, and end of operation.Anesthesia proceeding time, average recovery time, anesthesia effect assessment and cases of urinary reten-tion were recorded during and after operation.Results (1) HR, MAP, SpO2 were not significantly different at each time point in both groups(P>0.05).(2) Anesthesia proceeding time and average recovery time in the group of the nerve block were (3.0 ±0.8) min and (3.5 ±1.0)h respectively, in the group of combined spinal-epidural anesthesia were (14.8 ±1.0)min and(9.0 ±1.3)h re-spectively,with significant differences(P<0.05).(3) Anesthesia effect assessment: there were 28 cases of grade Ⅰand 2 cases of gradeⅡin the group of the nerve block , and 29 cases of gradeⅠand 1 case of gradeⅡin the group of combined spinal-epidural an-esthesia, there was no significant differences between the two groups.(4) Cases of urinary retention after operation in the group of nerve block (2 cases) was less than in the group of combined spinal-epidural anesthesia (12 cases)(P<0.05).Conclusions High ligation of hernial sac and indirect inguinal hernia repair for elderly patients under ilioinguinal-iliohypogastric nerve block is character-ized by simplicity and safety, good effect, rapid recovery and less complication.It is better than combined spinal-epidural anesthesia.
