【摘要】 目的探讨在基层医院开展局麻下无张力疝修补的可行性。方法 2015年6月至2017年3月,贵州省六盘水市人民医院利用科技项目基金资助,在县级及乡镇医院开展局麻下无张力疝修补治疗腹股沟疝19例患者临床资料。结果 19例患者行腹膜前间隙无张力疝修补术完成,麻醉方式为局麻,手术时间45～60 min,平均为50 min。术后均未用抗生素,术后6 h内即可下床活动及进流质饮食。患者无需要导尿,疼痛患者给予镇静剂。所有患者均达1期愈合,住院时间为3～4d。术后随访6～23个月,无复发、疼痛、异物感等不适。经济费用减少20%。结论局麻下无张力疝修补术在基层医院开展效果满意,即规范了腹股沟疝的治疗,同时患者术后疼痛小,恢复快,并发症少,复发低,降低患者经济费用,缓解就医困难,故此方式值得推广,也为医疗体制改革提供了依据。更多还原

【Abstract】 Objective To explore the feasibility of conducting tension-free hernioplasty with local anaesthesia in the grass-roots hospital. Methods From June 2015 to March 2017, we used the science and technology project fund to conduct inguinal hernia repair by using tension-free hernioplasty with local anaesthesia in country-level hospitals and township level hospitals for 19 patients and study their clinical data. Results 19 patients finished the tension-free hernia repair in the preperitoneal space, the anaesthesia was local anaesthesia, and the operation time was 45 to 60 minutes, with an average of 50 min.No antibiotics were used after surgery, and they were able to get out of bed and had a liquid food within 6 hours after operation. The patients did not need urine catheterization, and patients who felt pain were given sedation. All patients were healing by first intention, and the duration of hospitalization was 3 to 4 days.After 6 to 23 months of follow-up, there was no recurrence, pain, foreign body sensation, and other discomforts. The financial cost was reduced by 20%. Conclusions The effects of conducting tension-free hernioplasty with local anaesthesia in the grass-roots hospital were satisfied. On the one hand, it regulated the treatment of inguinal hernias. On the other hand, the patients had less postoperative pain, rapid recovery, fewer complications, low recurrence rate, reduced patient economic costs, and eased the medical difficulties. Therefore, this method is worth promoting and also provides a basis for the reform of the medical system.更多还原