摘要
目的：探讨局麻下使用巴德Modified Kugel补片腹膜前无张力修补伴有严重肺功能障碍、心脑血管疾病、脑梗塞等不能耐受全麻或椎管内麻醉的老年腹股沟疝患者的临床经验和疗效。方法回顾性分析2010年3月---2012年6月收治的53例经腹股沟切口腹膜前间隙置入MK补片进行无张力腹股沟疝修补术的病例，观察患者局麻效果、手术时间、术后恢复、以及随访观察术后远期并发症及复发情况。结果全部局麻成功，单侧手术时间35-45min，平均40min。术后疼痛感较明显3例，男性2例，女性1例。术后平均恢复2．5d。2例因术后发生阴囊积液住院时间延长至6-7天。术后平均随访20个月无复发，无明显异物感。结论应用巴德Modified Kugel补片局麻下腹膜前无张力修补治疗难治性腹股沟疝，具有术后恢复快、并发症少、住院时间短、术后复发率低等优点，尤其适用于伴有严重肺功能障碍、心脑血管疾病和（或）脑梗塞的不能耐受全麻手术的老年腹股沟疝患者。
Abstract
Objective To evaluate the curative effect and clinical experience of preperitoneal groin tension -free hernioplasty using modified kugel patch from BARD(USA)in old patients with pulmonary dysfunction,cardiovascular and cerebrovascular diseases and infarction that could not afford total or spinal anesthesia .Meth-od 53 patients with preperitoneal groin tension -free hernioplasty under local nerve blockade anesthesia with modified kugel patch from BARD ( USA) performing in a pe-riod of time from March,2010 to June,2012 were analyzed,including anesthetic effect,operation time,hospitalization time,long period follow-up complications and re-currences after surgery.Results All patients with local nerve blockade anesthesia were succeed;the operation time for each was 35 to 45 minutes,meanly 40 minutes.On-ly 3 patients had slight pain after surgery,2 of them were male,the other was female.The average time that patients stayed in hospital after surgery was 2.5 days.2 pa-tients suffered from scrotal hydrocele and extended to 6 or 7 days.NO one felt foreign body sensation and non-recurrences in average 20 months followed up.Conclusion The preperitoneal tension-free hernioplasty with modified kugel patch from BARD under local nerve blockade anaesthesia is a good way of curing refractory inguinal her-nia,it has the benefit of rapid recovery after operation,few complications,short stay in hospital and low recurrences,especially for those old patients with pulmonary dys-function,cardiovascular and cerebrovascular diseases and infarction that could not afford total or spinal anesthesia .
NETL
NSTL
万方数据