目的 了解局部麻醉下腹股溝疝無張力修補術后患者排便變化的相關影響因素。 方法 采用自行設計的問卷調查表，對2010年5月－6月行無張力修補術的腹股溝疝患者術后排便情況及變化進行調查，并就相關影響因素采用logistic回歸方法進行統計分析。 結果 腹股溝疝無張力修補術后患者進食量減少、活動量減少、飲食成分變化、擔心排便引起復發是術后排便變化的影響因素。 結論 加強該病癥術后健康宣傳，指導患者正常進食、多活動，消除患者對腹股溝疝復發的焦慮，可促進其早期排便。Objective To research on the risk factors for change of defecation after inguinal hernia mesh-repairs under local anesthesia. Methods Self-made questionnaires were used to investigate the defecation change among patients having undergone inguinal hernia mesh-repairs from May to June 2010, and the correlated factors for change of defecation were analyzed by logistic regression analysis. Results Reduction of activity and food, changes of food ingredients, and worries about recurrence were risk factors for change of defecation. Conclusion In order to facilitate the recovery of the patients, nurses should promote patients’ knowledge on the surgery, guide them to eat as usual and do more exercises, and eliminate their anxiety on recurrence of the disease.
Objective
To explore the effectiveness of tension-free herniorrhaphy with Ultrapro Plug (UPP) mesh through a femoris approach for femoral hernia repair.
Methods
Between March 2009 and January 2013, 123 patients (126 sides) underwent tension-free herniorrhaphy with UPP mesh through a femoris approach. There were 17 males and 106 females, aged 32-95 years (mean, 63.3 years). The locations were the left side in 48 cases, the right side in 72 cases, and both sides in 3 cases. The disease duration was 1 month to 26 years (median, 25 months). Of 123 cases, 35 cases (36 sides) were reducible and 88 cases (90 sides) were irreducible. According to American Society of Anesthesiologists (ASA) classification, 20 cases were rated as grade I, 42 cases as grade II, 56 cases as grade III, and 5 cases as grade IV. The operation time, postoperative hospitalization time, complication, recurrence, and chronic pain were recorded.
Results
The operation time was 7-28 minutes (mean, 14.5 minutes); postoperative hospitalization time was 2-96 hours (mean, 19.4 hours) (112 patients discharged from hospital within 24 hours). Wound dehiscence occurred in 1 case and fat liquefaction in 2 cases. A total of 119 patients (122 sides) were followed up 4-50 months (median, 18 months); no recurrence was noted. Two cases (2 sides) suffered from chronic pain after operation, whose visual analogue scale (VAS) was 20 mm and 30 mm, respectively.
Conclusion
Tension-free herniorrhaphy with UPP mesh through a femoris approach should be recommended because it has the advantages of simple operation, short operation time, less complication, and lower incidence of chronic pain.
