局部浸润麻醉+Modified Kugel修补在老年女性腹股沟疝患者中的临床应用

doi:10.3969/j.issn.2095-378X.2022.03.007

外科研究与新技术 ›› 2022, Vol. 11 ›› Issue (3): 170-173.doi: 10.3969/j.issn.2095-378X.2022.03.007

局部浸润麻醉+Modified Kugel修补在老年女性腹股沟疝患者中的临床应用

武振, 李文磊, 王永坤, 姚玉民, 崔兆清, 章阳, 张伟, 任仲喜

聊城市人民医院疝与腹壁外科,山东聊城 252000

收稿日期:2021-11-15 出版日期:2022-09-28 发布日期:2022-12-29
通讯作者: 任仲喜,电子信箱：renzx09@126.com
作者简介:武振（1985—）,男,硕士研究生,主治医师,从事临床疝与腹壁外科工作

Clinical application of preperitoneal modified Kugel hernia repair in elderly female patients with inguinal hernia under local infiltration anesthesia

WU Zhen, LI Wenlei, WANG Yongkun, YAO Yumin, CUI Zhaoqing, ZHANG Yang, ZHANG Wei, REN Zhongxi

Department of Hernia and Abdominal Wall Surgery, Liaocheng People's Hospital, Liaocheng 252000, Shandong, China

Received:2021-11-15 Online:2022-09-28 Published:2022-12-29

摘要/Abstract

摘要： 目的探讨局部浸润麻醉联合腹膜前的改良Kugel疝修补术在老年女性腹股沟疝患者中临床应用的效果。方法回顾性分析2017年9月—2020年9月收治的年龄>60岁的老年女性患者的临床资料,将采用局麻+Modified Kugel修补的患者作为研究对象。观察患者术后疼痛情况、恢复正常活动时间、术后并发症及随访中有无复发等情况。结果收集符合标准患者19例,年龄60~81岁,平均（64.5±3.3）岁。1例患者出现术后切口浅表感染,1例出现阴唇水肿,总体术后疼痛反应较轻,满意度良好。平均随访（13.0±3.0）个月,未见疝复发,无慢性疼痛患者出现。结论局部浸润麻醉联合腹膜前的改良Kugel疝修补术是高龄、不能耐受全麻手术的女性腹股沟疝患者的理想手术方式。

关键词: 老年, 女性, 腹股沟疝, 局部浸润麻醉, 腹膜前

Abstract: Objective To investigate the clinical effect of local infiltration anesthesia combined with preperitoneal modified Kugel hernia repair on inguinal hernia in elderly female patients. Methods The clinical data of elderly female patients over 60 years old admitted to our hospital from September 2017 to September 2020 were retrospectively analyzed, and patients receiving local anesthesia +modified Kugel repair were selected as study subjects. Postoperative pain, recovery time of non-restricted activity, recurrence of hernia, and complications during follow-up were observed. Results Nineteen patients who met the criteria were followed up, ranging in age from 60 to 81 years old, with an average age of （64.5±3.3） years. Superficial infection of postoperative incision occurred in 1 patient and labia edema occurred in 1 patient. Overall, postoperative pain response was mild and satisfaction was good. The average follow-up time was （13.0±3.0） months. No hernia recurrence was observed, and no chronic pain was found. Conclusion Local infiltration anesthesia combined with preperitoneal modified Kugel hernia repair is an ideal surgical procedure for elderly female inguinal hernia patients who cannot tolerate general anesthesia.

Key words: Elderly, Women, Inguinal hernia, Local infiltration anesthesia, Properitoneal

中图分类号:

R605

武振, 李文磊, 王永坤, 姚玉民, 崔兆清, 章阳, 张伟, 任仲喜. 局部浸润麻醉+Modified Kugel修补在老年女性腹股沟疝患者中的临床应用[J]. 外科研究与新技术, 2022, 11(3): 170-173.

WU Zhen, LI Wenlei, WANG Yongkun, YAO Yumin, CUI Zhaoqing, ZHANG Yang, ZHANG Wei, REN Zhongxi. Clinical application of preperitoneal modified Kugel hernia repair in elderly female patients with inguinal hernia under local infiltration anesthesia[J]. Surgical Research and New Technique, 2022, 11(3): 170-173.

参考文献

[1] Nilsson H, Holmberg H, Nordin P, et al.Groin hernia repair in women - A nationwide register study[J].Am J Surg,2018,216(2):274-279.
[2] Burcharth J, Pedersen M, Bisgaard T, et al.Nationwide prevalence of groin hernia repair[J]. PLoS One, 2013,8(1):e54367.
[3] Henriksen NA, Thorup J, Jorgensen LN.Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia[J]. Hernia, 2012, 16(4):381-385.
[4] Köckerling H, Koch A, Lorenz R.Groin hernias in women—A review of the literature[J]. Front Surg, 2019,6(4):1-8.
[5] Veenendaal NV, Simons M, Hope W, et al.Consensus on international guidelines for management of groin hernias[J].Surg Endosc, 2020,34(6):2359-2377.
[6] Herniasurge Group.International guidelines for groin hernia management[J]. Hernia, 2018,22(1):1-165.
[7] 陈思梦.老年(高龄)女性腹股沟疝诊断及治疗方案选择[J].中国实用外科杂志,2018,38(8):884-889.
[8] 陈亚东,郁春. 局麻下腹膜前间隙老年性腹股沟直疝修补术48例治疗体会[J]. 外科研究与新技术,2017,1(6):27-29.
[9] 武振,崔兆清,王永坤,等.超声引导下局部神经阻滞治疗老年腹股沟疝[J].中华普通外科学文献(电子版),2019,13(4):300-303.
[10] Fitzgibbons RJ, Forse RA.Clinical practice. Groin hernias in adults[J]. New Engl J Med, 2015,372(8):756-763.
[11] Beadles CA, Meagher AD, Charles AG.Trends in emergent hernia repair in the United States[J]. JAMA Surg, 2015,150(3):194-200.
[12] Kjaergaard J, Bay-Nielsen M, Kehlet H.Mortality following emergency groin hernia surgery in Denmark[J]. Hernia, 2010,14(4):351-355.
[13] Oma E, Bay-Nielsen M, Jensen KK, et al.Primary ventral or groin hernia in pregnancy: a cohort study of 20, 714 women[J].Hernia, 2017, 21(3):335-339.
[14] Kulaçoğlu H.Comments on the new groin hernia guidelines: What has changed? What has remained unanswered?[J]. Turk J Surg, 2018,34(2):83-88.
[15] Schmidt L, Stina Öberg, Andresen K, et al.Laparoscopic repair is superior to open techniques when treating primary groin hernias in women: a nationwide register-based cohort study[J]. Surg Endosc, 2019,33(1):71-78.
[16] 陈瑶,周抒,王光海,等.女性腹腔镜腹股沟疝修补术子宫圆韧带的处理方式[J].中华消化外科杂志,2018,17(11):1137-1140.
[17] 王骥,王文瑞,李健文,等.腹腔镜手术治疗女性腹股沟疝225例临床分析[J].中国实用外科杂志,2015,35(11):1220-1222.
[18] 陆朝阳,刘嘉铭.育龄期女性腹股沟疝治疗的处理策略[J].中华消化外科杂志,2020,19(7):738-741.
[19] 唐健雄, 郑民华, 陈杰,等.腹腔镜腹股沟疝手术操作指南(2017版)[J].中华疝和腹壁外科杂志(电子版),2017,11(6):401-406.
[20] 李航宇, 顾岩, 王明刚,等.老年腹股沟疝诊断和治疗中国专家共识(2019版)[J].中国实用外科杂志,2019,39(8):782-787.
[21] 孙惠军. 女性腹股沟斜疝的圆韧带与疝囊关系分型和处理[J].中华疝和腹壁外科杂志(电子版),2014,8(4):377-377.
[22] 杨伟斌. 生殖股神经的应用解剖学基础及临床意义[J].中国医药指南,2008,6(18):17-18.
[23] Wang Y, Wu T, Terry MJ, et al.Improved perioperative analgesia with ultrasound-guided ilioinguinal/iliohypogastric nerve or transversus abdominis plane block for open inguinal surgery: a systematic review and meta-analysis of randomized controlled trials[J]. J Phys Ther, 2016,28(3):1055-1060.
[24] 王凡冰,邓智超.罗哌卡因和利多卡因在局麻下老年腹股沟疝手术中的应用研究[J].中华疝和腹壁外科杂志(电子版),2020,14(4):388-391.

局部浸润麻醉+Modified Kugel修补在老年女性腹股沟疝患者中的临床应用

Clinical application of preperitoneal modified Kugel hernia repair in elderly female patients with inguinal hernia under local infiltration anesthesia

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	陈洋, 黄科满, 唐波, 黄俊朝. 超声引导下髂筋膜间隙阻滞复合单侧脊椎麻醉行髋关节置换术的临床研究[J]. 外科研究与新技术, 2022, 11(2): 104-107.
[2]	周辉, 蔡宜良, 陈家趁, 吴铁. 神经刺激仪引导的腰丛及坐骨神经阻滞在38例老年下肢手术的应用[J]. 外科研究与新技术, 2022, 11(2): 111-114.
[3]	杨涛, 黎炎华, 周颖. 超声引导下锁骨上臂丛神经阻滞在老年患者上肢骨折手术中的应用研究[J]. 外科研究与新技术, 2022, 11(1): 28-30.
[4]	吴铁, 陈家趁. 不同麻醉方式对老年髋部骨折患者术后认知功能及恢复的影响[J]. 外科研究与新技术, 2022, 11(1): 31-34.
[5]	张国强, 赵春江, 吴海滨, 欧键莹, 黄忠阳, 黎广祥. 超声引导腹横肌平面联合髂腹下神经阻滞行腹腔镜下腹股沟疝修补术的效果及并发症观察[J]. 外科研究与新技术, 2022, 11(1): 35-38.
[6]	陈红其, 李强, 刘奎, 李剑, 李恒. 老年肌层浸润性膀胱癌患者保留膀胱术后存活情况及影响因素分析[J]. 外科研究与新技术, 2021, 10(3): 179-181.
[7]	周小平, 谢清. L型腔镜拉钩在老年腹股沟疝TAPP治疗中的应用[J]. 外科研究与新技术, 2021, 10(2): 111-112.
[8]	王昌松, 张悦, 余得水, 姚洪林. 全麻复合硬膜外麻醉对老年膝关节置换术患者认知功能的影响[J]. 外科研究与新技术, 2021, 10(2): 128-130.
[9]	卢赓. TAPP与开放网塞加平片修补术治疗腹股沟疝的疗效对比分析[J]. 外科研究与新技术, 2021, 10(1): 17-18.
[10]	笪波, 徐文海. 腹腔镜疝修补术治疗成人腹股沟疝的临床疗效观察[J]. 外科研究与新技术, 2021, 10(1): 19-21.
[11]	吴海滨, 赵春江, 黄忠阳, 罗乃荣, 黎广祥, 欧键莹, 林凤仪. 低密度盐酸罗哌卡因单侧脊椎麻醉在老年髋部手术患者中的应用效果观察[J]. 外科研究与新技术, 2020, 9(3): 187-189.
[12]	李国锋. 腹腔镜经腹膜前疝补片植入修补术治疗235例单侧腹股沟疝疗效观察[J]. 外科研究与新技术, 2020, 9(2): 85-87.
[13]	桑鸿雁, 张敏. 腹腔镜疝修补术治疗腹股沟疝的效果分析[J]. 外科研究与新技术, 2019, 8(4): 234-236.
[14]	陈萍, 赵玉潮, 陈奎. 依托咪酯复合瑞芬太尼麻醉诱导对老年腹腔镜手术患者应激及早期术后认知功能的影响[J]. 外科研究与新技术, 2019, 8(3): 174-176.
[15]	黄伟, 周阿成, 孔萍. 痔动脉结扎联合胶圈套扎术治疗老年重度混合痔的疗效观察[J]. 外科研究与新技术, 2019, 8(2): 106-108.