They have been taking anticoagulants for high blood pressure, and their lungs, kidneys and liver are not functioning well. …… One out of every eight elderly people has a hernia, but even when faced with the dangers of intestinal obstruction, intestinal necrosis and acute abdomen, they all “shake their heads and wag their hands” when it comes to surgery for hernia. –They don’t want to. The reason for this is that the elderly are afraid of surgery, afraid that they will bleed more than once, that they will not wake up from anesthesia, and that their bodies will not tolerate it.
In fact, surgery for hernia no longer requires general anesthesia or lumbar anesthesia, and there is a perfect solution for the bleeding problem – local anesthesia can help the elderly to relieve their worries.
Case.
Drinking medicine to cure hernia led to intestinal intussusception
She noticed that the vague pain came from the right side of her lower abdomen, close to her thigh, and a small lump would protrude when she exerted herself.
At first, Granny Liu thought that the belly pain was caused by heavy dampness, so she dispelled the dampness herself. But soon after, she found that the small lumps were much larger and the pain was getting worse. She was sent to the hospital by her family and was diagnosed with a hernia, which required surgery.
The woman did not listen to the doctor and found someone to prepare her own medicine and boil it for her. The pain was so severe that she could not eat or sleep. The family insisted that Granny Liu be sent to Guangdong Provincial People’s Hospital, a checkup, due to delayed treatment, her intestinal tube has been embedded, stuck in the abdominal wall, if further late treatment may cause intestinal infarction, intestinal necrosis. Dr. Hu Shixiong, deputy chief of the vascular thyroid abdominal wall hernia surgery of the hospital, arranged an open surgery with local anesthesia for her, which was very successful, and Granny Liu was discharged the next day.
Data.
The incidence rate of 11.8% in people over 60 years old.
Hernia, also known as “small intestine gas”. The abdominal wall becomes weak or defective due to ageing, muscle atrophy and increased abdominal pressure. The contents of the abdominal cavity bulge out through the weakness or defect in the abdominal wall, forming a sac into which a segment of the intestine or other abdominal organs enters, forming a hernia. When a patient has a hernia, a lump is commonly raised in the groin, abdominal wall, navel, scrotum, etc. It disappears when pressed or lying down, but the symptoms are obvious when standing for a long time, walking, exerting oneself, coughing hard and children crying.
Hernia is a common disease, and the total prevalence of hernia in China is as high as 3.6%. The incidence of inguinal hernia is 3%. ~5%. The incidence rate is higher in the elderly, with 11.8% of the elderly over 60 years old in China. , and as of the end of 2014, the number of elderly people over 60 years of age registered in Guangdong Province has reached 11.92 million, which means that 1.4 million elderly people are suffering from hernia.
Children, middle-aged and elderly, men, long-term constipation, cough, obesity, pregnancy, heavy physical work and the presence of prostate disease are all factors in the occurrence of hernia. Among them, the highest prevalence rate is in older men. This is because men are more likely to develop a hernia during development, as the testicles descend from the body, creating a natural space in the abdominal cavity that is 12 to 14 times more likely to develop than women. When men reach old age, the abdominal wall is more like “old washed clothes” with weak muscles, theoretically speaking, if men live long enough to 130 years old, they will definitely grow a hernia.
Analysis.
Fear of surgery, the elderly are more mute hernia
Despite the prevalence of hernia, there are very few people who treat hernia correctly – the Department of Vascular Thyroid Ventral Wall Hernia Surgery of Guangdong Provincial People’s Hospital is the largest hernia treatment center in South China, but only 1000 cases of hernia patients are treated in a year.
More elderly people, especially those with combined chronic diseases, either do not know that surgery is the only way to cure hernia or are unwilling to have surgery to cure hernia, so they “treat” hernia by conservative methods such as injecting sclerosing agent, taking medicine and wearing hernia belt. For this reason, patients believe that they have been taking anticoagulants for hypertension, and their lungs, kidneys and liver are not functioning well. …… are afraid of surgery, afraid that they will bleed more than once, that they will not wake up from anesthesia, and that their bodies will not be able to withstand it.
However, non-surgical “treatment” of hernia is not only not the right diagnosis, but also a new way to suffer in silence. Once the hernia becomes difficult to retract, it will easily lead to intussusception and induce intestinal obstruction, intestinal necrosis and other dangerous situations; on the other hand, the hernia will become an emergency situation, and once it forms an acute abdomen, it may be fatal.
Progress.
Local anesthesia surgery can be done even for 100-year-olds
Surgery is the only proper way to treat hernia in adults, and it has “evolved” to outpatient surgery and 24-hour access to hospitals. More than 90% of the surgeries at Guangdong Provincial People’s Hospital are performed under local anesthesia, and more than 80% of the patients are elderly, with the youngest patient being 10 years old and the oldest patient being 104 years old, meaning that even centenarians can tolerate hernia surgery.
Traditional surgery for hernia requires a large incision, general anesthesia or lumbar puncture anesthesia, fasting, insertion of urinary and gastric catheters, no exertion for one month and no strenuous exercise for three months after surgery. In addition, chronic diseases such as diabetes, coronary heart disease, emphysema, cirrhosis of the liver (ascites), etc. are all contraindications to surgery.