围手术期多模式预处理在局麻腹股沟疝修补术的应用体会

doi:10.3969/j.issn.1009-976X.2026.04.008

摘要/Abstract

摘要： 目的探讨围手术期多模式预处理干预下的局麻腹股沟疝无张力修补术的有效性及安全性。方法本研究采用前瞻性研究方法,将入组的87例患者分为试验组与对照组。试验组遵循快速康复外科理念,采用围手术期多模式预处理干预下的局麻腹股沟疝无张力修补术;对照组采用椎管内麻醉下的腹股沟疝无张力修补术。分析比较两组在术后30 min、2 h、4 h、6 h、12 h及24 h的视觉模拟量表（VAS）评分;分析比较两组在住院时间、住院费用及并发症发生率方面的差异。结果试验组的VAS评分在术后2 h（3.47±1.06 vs. 5.55±1.25）、4 h（3.29±1.01 vs. 5.57±1.11）、6 h（3.87±1.12 vs. 5.79±1.26）、12 h（4.11±1.09 vs. 5.50±1.11）及24 h（2.98±1.01 vs. 4.43±1.09）均低于对照组（均P<0.05）;试验组住院时间（4.33±1.09 vs. 5.21±1.12 d）和费用（4106.4±155.1元vs. 5477.1±206.4元）均低于对照组（均P<0.05）。两组术后并发症发生情况差异无统计学意义（P>0.05）,术后随访6~18个月,未发生复发或其他并发症。结论采用围手术期多模式预处理对行局部麻醉下腹股沟疝无张力修补术的患者进行干预,可显著降低术后早期疼痛评分,缩短住院时间,减少住院费用,且未观察到并发症发生风险或短期复发风险增加。

关键词: 腹股沟疝, 无张力修补术, 局部麻醉, 围手术期, 快速康复外科, 多模式预处理

Abstract: Objective To explore the effectiveness and safety of tension-free inguinal hernia repair under local anesthesia with perioperative multimodal pre-intervention. Methods A prospective study was conducted. A total of 87 patients who met the inclusion criteria were divided into two groups： a treatment group and a control group. The patients in the treatment group, who underwent tension-free inguinal hernia repair under local anesthesia, were treated with perioperative multimodal pre-intervention guided by the concept of fast-track surgery. The patients in the control group underwent tension-free inguinal hernia repair under spinal anesthesia. The postoperative pain scores of the two groups were compared at 30 minutes, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours after surgery. The length of postoperative hospital stay, hospitalization costs, and the incidence of complications were also compared between the two groups. Results The visual analog scale （VAS） scores in the treatment group were lower than those in the control group at 2 h （3.47±1.06 vs. 5.55±1.25）, 4 h （3.29±1.01 vs. 5.57±1.11）, 6 h （3.87±1.12 vs. 5.79±1.26）, 12 h （4.11±1.09 vs. 5.50±1.11）, and 24 h （2.98±1.01 vs. 4.43±1.09） postoperatively （all P<0.05）; the length of hospital stay （4.33±1.09 vs. 5.21±1.12 d） and cost （4106.4±155.1 yuan vs. 5477.1±206.4 yuan） in the treatment group were also lower than those in the control group （all P<0.05）. There was no difference in the incidence of postoperative complications between the two groups （P>0.05）. No recurrence or other complications occurred during a follow-up of 6~18 months in either group. Conclusion Perioperative multimodal pre-intervention for patients undergoing tension-free inguinal hernia repair under local anesthesia can reduce early postoperative pain scores, shorten hospital stay, and lower hospitalization costs, without observed increases in complications or short-term recurrence risk.

Key words: Inguinal hernia, tension-free repair, local anesthesia, perioperative period, enhanced recovery after surgery, perioperative multimodal pre-intervention

中图分类号:

王亮, 刘梅宝, 赖家骏, 翁伟明, 谭逸衍. 围手术期多模式预处理在局麻腹股沟疝修补术的应用体会[J]. 岭南现代临床外科, 2026, 25(04): 260-264.

WANG Liang, LIU Meibao, LAI Jiajun, WENG Weiming, TAN Yiyan. Application of perioperative multimodal preintervention in inguinal hernia repair under local anesthesia[J]. Lingnan Modern Clinics In Surgery, 2026, 25(04): 260-264.

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