[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fD_ERkEGSPmCKCvm2KVM6x8BYCEBSMTieqRLKDLOqpUo":8,"$fBuryC5qggF0R7M8l21YEFbchZ3xMebSZr6nHm51qUVA":56,"$fU37RgwSA0RFRQwFs8VvrInkUVew59BXjByTsY7qzJn8":60},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":55},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"hospital":17,"department":18,"postsTitle":19,"materialTotal":20,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"content":25,"description":26,"views":27,"likes":21,"isThumbsUp":7,"isCollection":7,"collections":21,"createTime":28,"seoTitle":29,"seoKeywords":30,"seoDescription":31,"shelvesTime":32,"version":33,"menus":34,"menuId":36,"type":43,"quality":54,"commentCount":21,"isComment":43},82378,876849,[],"https://yst.tos-cn-shanghai.volces.com/venue%2Fundefined%2F2025-12-16-16%3A11%3A04%2F76060049-1dff-40f7-88f3-c646c1d87a63.png","付卓","吉林大学第二医院","麻醉科","主治医师",9,0,"单侧腹股沟疝手术的麻醉管理：策略优化与临床实践","","https://ystcdn.venuertc.com/venue/AI/960be448-69e4-4404-88a8-0b466bd9840f.jpg","\u003Ch1 align=\"center\" style=\"margin-top:0.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;text-align:center;\nline-height:17.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 12pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">单侧腹股沟疝手术的麻醉管理：策略优化与临床实践\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 12pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h1>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">腹股沟疝修补术是普外科最常见的手术之一，其中单侧腹股沟疝占据绝大多数。尽管手术本身相对简单、时间较短，但麻醉管理的质量直接影响患者术后恢复速度、并发症发生率以及住院时间。面对日益多元化的麻醉技术和加速康复外科理念的普及，如何为单侧腹股沟疝手术选择最合适的麻醉方案，成为麻醉医生日常工作中的重要课题。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Ch2 style=\"margin-top:16.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:16.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 11pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">一、患者特点与麻醉挑战\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 11pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h2>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">单侧腹股沟疝可发生于各年龄段，从婴幼儿到高龄老年人均可见。成人患者中，中老年男性占比最高，常合并高血压、冠心病、慢性阻塞性肺疾病、糖尿病等基础疾病。老年患者往往存在多重用药、器官功能储备下降、认知功能减退等问题，这些因素显著增加了麻醉风险。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">此外，部分患者因疝内容物嵌顿需急诊手术，可能伴有肠梗阻、水电解质紊乱甚至感染性休克，进一步提升了麻醉管理的复杂性。因此，麻醉方案必须个体化，权衡手术需求与患者耐受性。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Ch2 style=\"margin-top:16.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:16.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 11pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">二、麻醉方式的选择与比较\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 11pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h2>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">目前，单侧腹股沟疝手术可采用的麻醉方式包括局部麻醉、区域阻滞麻醉（椎管内麻醉）、外周神经阻滞以及全身麻醉。不同方式各有优劣，选择依据主要包括患者病情、手术方式（开放或腹腔镜）、外科医生偏好以及麻醉医生经验。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">局部麻醉\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">适用于开放疝修补术，尤其适合高龄、合并严重心肺疾病、无法耐受其他麻醉方式的患者。局麻下患者保持清醒，可主动配合咳嗽等动作，避免了全麻或椎管内麻醉的血流动力学波动。但局麻的镇痛范围有限，部分患者术中可能感到牵拉不适，且对患者的心理承受能力有一定要求。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">椎管内麻醉\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">（腰麻或硬膜外麻醉）曾是腹股沟疝手术的经典麻醉方式，可提供完善的镇痛和肌松效果，患者术中清醒，避免了气管插管相关并发症。然而，椎管内麻醉可能引起低血压、尿潴留、术后头痛等并发症，且对于接受抗凝治疗的患者存在禁忌。值得注意的是，对于腹腔镜疝修补术，气腹刺激可能引发肩部牵涉痛，单纯椎管内麻醉往往难以完全抑制膈肌刺激反射。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">外周神经阻滞\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">，特别是髂腹下神经和髂腹股沟神经阻滞，联合或不联合生殖股神经阻滞，为腹股沟区手术提供了精准的麻醉方案。在超声引导下实施神经阻滞，可显著提高成功率、减少局麻药用量，并降低血管损伤风险。该技术血流动力学影响小，保留了下肢运动功能，术后镇痛效果持久，尤其适合日间手术。其局限性在于对操作者技术要求较高，且单独使用可能无法满足腹腔镜手术的需要。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">全身麻醉\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">是目前腹腔镜腹股沟疝修补术的首选。全麻可有效控制气道，耐受气腹引起的膈肌上抬和腹内压升高，提供稳定的手术条件。现代全麻药物起效快、代谢迅速，配合喉罩或气管插管，患者苏醒质量高。但对于高龄或合并严重心肺疾病的患者，全麻的诱导和拔管期心血管反应仍需谨慎处理。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Ch2 style=\"margin-top:16.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:16.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 11pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">三、加速康复外科理念下的麻醉策略\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 11pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h2>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">加速康复外科在腹股沟疝手术中的应用已日趋成熟，麻醉管理在其中扮演核心角色。核心目标包括：减少围术期应激反应、优化镇痛、促进早期活动和恢复经口进食。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">术前准备\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">\u003Cfont face=\"Segoe UI\">应避免长时间禁食，鼓励术前\u003C/font>2小时饮用清流质。术前无需常规使用镇静药物，以免延迟苏醒。对于焦虑患者，可给予短效抗焦虑药物。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">术中管理\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">\u003Cfont face=\"Segoe UI\">强调多模式镇痛。单纯依赖一种麻醉方式往往难以达到理想效果，联合应用局部浸润、神经阻滞和低剂量全麻药物可显著减少阿片类药物的用量，降低恶心呕吐、呼吸抑制等不良反应。对于开放手术，超声引导下的髂腹下\u003C/font>/髂腹股沟神经阻滞联合术中切口局部浸润，配合非甾体抗炎药，可提供完善的术后镇痛。对于腹腔镜手术，全麻联合术前行腹横肌平面阻滞或切口局部浸润，同样能有效降低术后疼痛评分。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">液体管理\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">方面，单侧腹股沟疝手术通常创伤小、出血少，应避免过度输液，以维持术前正常血容量为宜。老年患者尤其应警惕液体超负荷。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">预防恶心呕吐\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">\u003Cfont face=\"Segoe UI\">是促进早期恢复的关键。术后恶心呕吐不仅影响患者体验，还延迟出院。对于存在危险因素的患者（女性、非吸烟者、有术后恶心呕吐史、使用阿片类药物），应常规联合使用两种以上止吐药物，如地塞米松联合\u003C/font>5-HT3受体拮抗剂。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Ch2 style=\"margin-top:16.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:16.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 11pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">四、特殊人群的麻醉考量\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 11pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h2>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">老年患者\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">常合并认知功能障碍，应优先选择对中枢神经系统影响小的麻醉方式。区域阻滞或神经阻滞保留了患者的意识状态，避免了全麻后谵妄的风险。若需全麻，应选用血浆清除率高、无活性代谢产物的药物，如丙泊酚、瑞芬太尼，并监测脑电双频指数以避免麻醉过深。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">儿童患者\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">\u003Cfont face=\"Segoe UI\">的单侧腹股沟疝手术，全麻联合骶管阻滞或髂腹下\u003C/font>/髂腹股沟神经阻滞是常用方案。需特别注意气道管理的安全性及术后疼痛评估。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cb>\u003Cspan class=\"15\" style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">抗凝患者\u003C/span>\u003C/b>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">的管理需权衡血栓风险与椎管内血肿风险。接受抗血小板或抗凝治疗的患者，行椎管内麻醉前应参照相关指南评估停药时间。外周神经阻滞的风险相对较低，但同样需谨慎评估。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Ch2 style=\"margin-top:16.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:16.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 11pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">五、日间手术模式的麻醉要求\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 11pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h2>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">腹股沟疝修补术是日间手术的理想病种，麻醉管理必须满足快速苏醒、疼痛控制充分、恶心呕吐发生率低、出院后镇痛可持续等要求。短效麻醉药物、局部麻醉技术、非阿片类镇痛药的合理应用是日间手术成功的基石。出院前应确保患者无活动性出血、可自行排尿、疼痛可口服药物控制。\u003C/span>\u003Cspan style=\"mso-spacerun:'yes';font-family:Calibri;mso-fareast-font-family:宋体;\nmso-bidi-font-family:'Times New Roman';font-size:12.0000pt;mso-font-kerning:1.0000pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/p>\u003Ch2 style=\"margin-top:16.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:16.0000pt;\">\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 11pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">结语\u003C/span>\u003C/b>\u003Cb>\u003Cspan style=\"font-family: "Segoe UI"; font-size: 11pt;\">\u003Co:p>\u003C/o:p>\u003C/span>\u003C/b>\u003C/h2>\u003Cp class=\"p\" style=\"margin-top:8.0000pt;margin-right:22.0000pt;margin-bottom:0.0000pt;\nmargin-left:22.0000pt;mso-pagination:widow-orphan;line-height:14.0000pt;\">\u003Cspan style=\"font-family: "Segoe UI"; color: rgb(15, 17, 21); letter-spacing: 0pt; font-size: 8pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;\">单侧腹股沟疝手术的麻醉管理看似简单，实则蕴含丰富的临床决策点。没有一种麻醉方式适用于所有患者，麻醉医生需综合评估患者状况、手术需求和医疗资源，制定个体化方案。在加速康复外科理念指导下，多模式镇痛、最小化阿片类药物使用、预防恶心呕吐、促进早期活动应贯穿始终。随着超声引导神经阻滞技术的普及和新型短效麻醉药物的应用，腹股沟疝手术的麻醉正在向更精准、更安全、更舒适的方向发展，为广大患者带来更好的围术期体验。\u003C/span>\u003C/p>","\u003Ch1 align=\"center\" style=\"margin-top:0.0000pt;margin-right:22.0000pt;margin-bottom:8.0000pt;\nmargin-",473,"2026-04-13 16:17:20","单侧腹股沟疝与麻醉科的专业视角：一份实用的健康指南","单侧腹股沟疝, 麻醉科, 老年手术, 腹股沟包块, 疝气治疗, 风险监测, 微创手术, 疼痛管理","了解单侧腹股沟疝的定义、风险及治疗选择，特别是老年患者如何安全手术与麻醉。这份专业指南帮助你识别症状，及时就医，保障健康。","2026-04-17 22:00:00",2,[35],{"menuId":36,"menuName":37,"parentId":21,"orderNum":33,"path":38,"component":39,"isFrame":40,"isCache":41,"menuType":42,"visible":43,"status":21,"createDept":6,"remark":23,"createTime":44,"children":45,"columnImage":46,"columnLogo":47,"uncheckedLogo":6,"checkedLogo":6,"isHot":43,"isHome":21,"forceLogin":21,"color":48,"seoTitle":49,"seoKeywords":50,"seoDescription":51,"contentNum":6,"promotionalPoster":52,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":53,"routerPath":38,"componentInfo":39},"1986713082609147906","健康科普","article","/article.html","1","0","T",1,"2025-11-07 16:31:25",[],"https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:49/d4291d16-ed1c-48dd-84c8-ec1f85980b75.png","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:52/6fe64094-9416-442c-a66d-032fb292666a.png","#c8e6ca","健康科普助力健康中国2030:共享健康知识新理念","健康科普, 健康中国, 科普知识, 健康家庭, 性健康, 营养健康, 运动健康, 科普宣传","探索健康科普在健康中国行动中的重要角色,了解最新的健康科普创新大赛、动漫及短视频,传播健康知识,助力全民健康。","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:56/bd33f471-6c54-4d1b-a364-b06973dbc144.png","Article","慢性病,高发轻症,心理健康,传染病,癌症肿瘤,重大疾病,口腔疾病,过敏性疾病,儿童疾病,运动损伤,皮肤健康,上班常见病",true,{"code":9,"msg":10,"message":6,"data":57,"success":55},{"pageNo":43,"pageSize":58,"result":59,"totalSize":21},10,[],{"code":9,"msg":10,"message":6,"data":61,"success":55},{"authors":62,"appraiseDimensionScoresVos":63},[],[]]