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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 258 -261. doi: 10.3877/cma.j.issn.1674-392X.2022.03.002

临床论著

局部冰敷对腹股沟疝修补术后伤口疼痛及渗出的影响
陆安清1, 谢妍妍1, 简福顺1, 张森1, 马东扬1, 宋应寒1, 雷文章1,†()   
  1. 1. 610041　成都，四川大学华西医院胃肠外科中心
  • 收稿日期:2021-10-21 出版日期:2022-06-20
  • 通信作者: 雷文章

Effect of local ice compress on postoperative incision pain and exudation after inguinal hernia repair

Anqing Lu1, Yanyan Xie1, Fushun Jian1, Sen Zhang1, Dongyang Ma1, Yinghan Song1, Wenzhang Lei1,†()   

  1. 1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2021-10-21 Published:2022-06-20
  • Corresponding author: Wenzhang Lei
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陆安清, 谢妍妍, 简福顺, 张森, 马东扬, 宋应寒, 雷文章. 局部冰敷对腹股沟疝修补术后伤口疼痛及渗出的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(03): 258-261.

Anqing Lu, Yanyan Xie, Fushun Jian, Sen Zhang, Dongyang Ma, Yinghan Song, Wenzhang Lei. Effect of local ice compress on postoperative incision pain and exudation after inguinal hernia repair[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(03): 258-261.

目的

探讨局部冰敷对腹股沟疝修补术后伤口疼痛及渗出的影响。

方法

选取2017年12月至2018年3月四川大学华西医院收治的单侧原发性腹股沟疝患者60例，随机分为冰敷组和对照组，每组患者30例，均采用局部麻醉下腹股沟疝无张力修补术。冰敷组在术后常规治疗的基础上局部加用挤压后医用冰袋冰敷，对照组在术后常规治疗的基础上局部加用非挤压医用冰袋压迫。观察2组术后24 h内患者静息状态的疼痛视觉模拟评分（VAS），术后需要追加止痛药物数量及术后切口敷料的渗出例数及面积。

结果

冰敷组在术后6、12、24 h的VAS评分明显低于对照组，差异有统计学意义（P<0.05）；冰敷组术后镇痛药使用数量6例（20.0%）低于对照组21例（70.0%），差异有统计学意义（P<0.001）；冰敷组术后切口敷料渗出2例（6.7%），低于对照组6例（20%），但差异无统计学意义（P>0.05）。切口敷料渗出患者中，冰敷组平均渗出面积（0.30±0.71）cm2低于对照组（4.18±2.54）cm2，但差异无统计学意义（P>0.05）。2组术后的切口均顺利愈合。

结论

局部冰敷为腹股沟疝修补术的患者提供了一种安全、有效且副作用少的止痛方式，但其对伤口渗出的影响有待更进一步研究。

关键词: 疝，腹股沟, 无张力修补术, 局部冰敷, 疼痛, 渗出
Objective

To investigate the effect of local ice compress on incision pain and exudation after inguinal hernia repair.

Methods

A total of 60 patients with unilateral primary inguinal hernia in the West China Hospital of Sichuan University from December 2017 to March 2018 were enrolled. They were randomly divided into two groups: ice compress group (30 cases) and control group (30 cases). All patients underwent tension-free inguinal hernia repair under local anesthesia. On the basis of routine treatment after operation, ice compress group was locally applied with extruded medical ice bag, and the control group was locally applied with non-extruded medical ice bag. The visual analogue score (VAS) degree of pain within 24 hours after operation, the amount of analgesic drugs, and the number and area of postoperative incision dressing exudation were collected and compared between two groups.

Results

The VAS scores of ice compress group were significantly lower than that of the control group at 6, 12, and 24 hours postoperatively, the difference between the two groups was statistically significant (P<0.05). Furthermore, the number of analgesics used in the ice compress group [6(20%)] after operation was significantly less than that in the control group [21(70%)], and the difference between the two groups was significant (P<0.001). There were two cases (6.7%) and 6 patients (20%) had incision dressing exudation in the ice compress group and the control group, respectively, and no significant difference between the two groups was observed (P>0.05). In patients with incision dressing exudation, the average exudation area in the ice compress group (0.30±0.71) cm2 was less than that in the control group (4.18±2.54) cm2. However, there was no significant difference between the two groups (P>0.05). The incision healed smoothly after operation in both groups.

Conclusion

Local ice compress provides a safe, effective and less side effect way to relieve pain for patients undergoing inguinal hernia repair, but its effect on wound exudation needs further study.

Key words: Hernia, inguinal, Tension-free repair, Local ice compress, Pain, Exudation
表1 冰敷组与对照组患者基线资料比较
组别 例数 男性/女性(例) 年龄(岁, ±s) 体质量指数(kg/m2, ±s) 直疝/斜疝(例) 手术时间(min, ±s) 局麻药用量(ml, ±s)
冰敷组 30 29/1 73.03±8.83 21.67±3.12 9/21 35.40±5.18 69.17±5.88
对照组 30 30/0 76.07±5.26 22.87±2.10 7/23 37.07±5.61 71.00±6.07
统计值   1.017 -1.617 -1.738 0.341 -1.195 -1.187
P值   1.000 0.111 0.088 0.559 0.237 0.240
表2 冰敷组和对照组术后疼痛视觉模拟评分比较（分，±s）
组别 例数 术毕 术后2 h 术后6 h 术后12 h 术后24 h
冰敷组 30 0.27±0.52 1.43±0.77 1.57±0.68 2.03±1.00 2.43±1.20
对照组 30 0.30±0.60 1.77±0.77 2.33±1.03 3.30±1.30 3.6±1.55
t值   -0.231 -1.668 -3.408 -4.144 -2.754
P值   0.818 0.101 0.001 <0.001 0.009
表3 冰敷组和对照组术后使用止痛药及切口渗出例数比较
组别 例数 止痛药[例(%)] 切口敷料渗出[例(%)] 平均渗出面积(cm2, ±s)
冰敷组 30 6(20.0) 2(6.7) 0.30±0.71
对照组 30 21(70.0) 6(20.0) 4.18±2.54
统计值   15.152 - -2.051
P值   <0.001 0.254 0.086
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