超声引导下注药治疗腹股沟疝术后疼痛的疗效

doi:10.3877/cma.j.issn.1674-392X.2020.02.012

目的

探讨超声引导下注药治疗腹股沟疝术后疼痛并发症应用价值的初步评估。

方法

回顾性分析2018年6月至2019年8月，解放军总医院第一医学中心超声诊断科治疗15例因腹股沟疝术后不明原因且无法缓解疼痛的患者，行超声引导下对髂腹下神经、髂腹股沟神经及生殖股神经生殖支周围软组织区域进行注药治疗，应用疼痛视觉模拟评分（VAS）来分别评估术前、术后24 h、48 h、2周、4周的疼痛缓解情况。

结果

在超声引导下进行髂腹下神经、髂腹股沟神经及生殖股神经生殖支周围软组织区域注药治疗后，患者短期疼痛明显缓解，24 h尤为显著，术前、术后24 h、48 h、2周、4周的VAS评分比较分别为（3.5±0.8）、（0.7±0.8）、（1.5±1.0）、（2.5±0.8）、（2.7±0.8）分，治疗前与治疗后各时间点比较，差异均有统计学意义（P<0.05），但治疗术后2周与4周的VAS评分比较，差异无统计学意义（P>0.05）。

结论

超声引导下注药治疗腹股沟疝术后疼痛，短期临床效果显著，且具有实时引导、安全、无辐射等优点，故可作为临床缓解腹股沟疝术后疼痛的一种有效的治疗方法。

关键词: 神经阻滞, 超声引导下, 超声检查, 疝，腹股沟, 疼痛

Objective

To evaluate the value of ultrasound-guided drug injection in the treatment of pain complications after inguinal hernia surgery.

Methods

From June 2018 to August 2019, 15 patients who could not relieve the pain after inguinal hernia operation were treated by injecting medicine into the soft tissue area around the iliohypogastric nerve, ilioinguinal nerve and genitourinary branch of genitourinary nerve under the guidance of ultrasound. The visual analogue scale (VAS) was used to evaluate the pain relief before and at 24 hours, 48 hours, 2 weeks and 4 weeks after operation.

Results

After the drug injection under the guidance of ultrasound, the pain was relieved in a short period of time, especially in 24 hour. There was no significant difference in VAS score between 2 weeks and 4 weeks after block operation (P>0.05). There was significant difference in other groups (P<0.05).

Conclusions

Ultrasound-guided drug injection therapy can relieve the pain after inguinal hernia operation effectively in a short time, and the clinical effect is remarkable. Therefore, it should be used as a safe and effective method to relieve the pain after inguinal hernia operation.

Key words: Nerve block, Ultrasound guided, Ultrasonography, Hernia, inguinal, Pain

图4 超声显示腹股沟区内侧精索静脉区生殖股神经生殖支神经区域注药（箭头所示），穿刺针（箭头端所示）

图5 15例患者治疗前与治疗后各时间点疼痛视觉模拟评分比较

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Preliminary evaluation of value of ultrasound-guided drug injection in the treatment of pain complications after inguinal hernia surgery

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Preliminary evaluation of value of ultrasound-guided drug injection in the treatment of pain complications after inguinal hernia surgery