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中华疝和腹壁外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 265 -269. doi: 10.3877/cma.j.issn.1674-392X.2020.03.014

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临床论著

不同手术路径下腹股沟疝修补术后疼痛比较及慢性疼痛因素分析
陈晓鑫1,()   
  1. 1. 510000 广州,广东省第二中医院外二科
  • 收稿日期:2019-03-12 出版日期:2020-06-18
  • 通信作者: 陈晓鑫

Comparison of postoperative pain and risk factors analysis of chronic pain in patients under inguinal hernia repair via different surgical approaches

Xiaoxin Chen1,()   

  1. 1. Department of Second Surgery, Guangdong Province Second Traditional Chinese Medicine Hospital, Guangzhou 510000, China
  • Received:2019-03-12 Published:2020-06-18
  • Corresponding author: Xiaoxin Chen
  • About author:
    Corresponding author: Chen Xiaoxin, Email:
引用本文:

陈晓鑫. 不同手术路径下腹股沟疝修补术后疼痛比较及慢性疼痛因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(03): 265-269.

Xiaoxin Chen. Comparison of postoperative pain and risk factors analysis of chronic pain in patients under inguinal hernia repair via different surgical approaches[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(03): 265-269.

目的

探究不同手术路径下腹股沟疝修补术后疼痛比较及慢性疼痛因素分析。

方法

选取2016年2月至2018年1月,广东省第二中医院进行手术治疗的腹股沟疝患者150例,根据单双数字法将患者分为无张力组和腹腔镜组,每组75例。无张力组采用无张力修补术,腹腔镜组采用腹腔镜下腹股沟疝修补术。观察并比较2组患者的急性和慢性疼痛情况,并采用Logistic模型探讨影响慢性疼痛的因素。

结果

腹腔镜组的手术时间长于无张力组,术后住院时间、术中出血量、术后下床活动时间均低于无张力组,差异有统计学意义(P<0.05)。腹腔镜组患者的社会功能、生理职能、情感职能、精神状态、躯体疼痛和精力得分均高于无张力组,差异有统计学意义(P<0.05)。腹腔镜组术后1、3、5 d的疼痛评分均低于无张力组,差异有统计学意义(P<0.05)。术后6和12个月,腹腔镜组慢性疼痛率为4.00%和2.67%,无张力组为3.33%和12.00%,差异有统计学意义(P<0.05)。Logistic回归分析显示年龄<45岁、性别为女、有吸烟史、疝环直径>3.0 cm和切口感染是术后6个月慢性疼痛的危险因素,腹腔镜手术是保护因素。

结论

腹腔镜腹股沟疝修补术能显著降低术后早期疼痛,是腹股沟疝修补术后慢性疼痛的保护因素。

Objective

To compare the postoperative pain and to analyze risk factors of chronic pain in patients under inguinal hernia repair via different surgical approaches.

Methods

A total of 150 cases with inguinal hernia in Guangdong Province Second Traditional Chinese Medicine Hospital were randomly divided into the tension-free group (75 cases) and the laparoscope group (75 cases). The tension-free group used tension-free hernia repair, and the laparoscope group used laparoscopic inguinal hernia repair. The acute pain and chronic pain were compared between two groups, and the risk factors of chronic pain were analyzed by Logistic model.

Results

The operation time of the laparoscopic group was longer than that in the tension-free group, and the postoperative hospitalization time, intraoperative blood loss and postoperative time to get out of bed were lower than those in the tension-free group, with significant differences (P<0.05). The scores of social function, physiological function, emotional function, mental state, physical pain and energy in the laparoscopic group were higher than those in the tension-free group, with significant differences (P<0.05). The scores of pain in the laparoscopic group at 1d, 3d, and 5d after surgery were lower than those in the tension-free group, with significant differences (P<0.05). The rate of pain at 6 months and 12 months after surgery in the laparoscopic group were 4.00% and 2.67%, respectively, and those in the tension-free group were 3.33% and 12.00%, with significant difference (P<0.05). The Logistic regression analysis showed that age < 45 years, female, smoking history, hernia ring diameter > 3.0 cm and incision infection were risk factors for chronic pain at 6 months after surgery. However, the laparoscopic was the protective factor of the chronic pain.

Conclusion

The laparoscopic inguinal hernia repair can reduce early postoperative pain, and is a protective factor for chronic pain after inguinal hernia repair.

表1 2组腹股沟疝患者手术指标比较(±s
表2 2组患者生活质量SF-36得分比较(分,±s
表3 2组腹股沟疝患者早期疼痛评分比较(分,±s
表4 2组腹股沟疝患者术后慢性疼痛比较(例)
表5 2组腹股沟疝患者术后6个月慢性疼痛多因素分析
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