探讨开放腹股沟疝修补术后疼痛的相关因素。

前瞻性收集2016年3月至2018年2月中日友好医院普外科进行手术治疗的腹股沟疝患者188例。所有手术均由同一位主刀医师完成。收集患者的基本临床信息，利用数字量表评分（NRS）对患者术前输液穿刺疼痛，术后6、24 h伤口疼痛程度进行评估。相关性分析采用Pearson相关分析和Spearman秩相关分析。采用多因素Logistic回归分析风险因素与疼痛的独立相关关系。

术后6 h伤口疼痛与年龄呈负相关（R=-0.152，P<0.05）。与麻醉方式具有显著相关性（R=0.164，P<0.05）。与性别、体质量指数（BMI）、手术部位、腹股沟疝分型、手术方式、手术时间无显著相关性。术后24 h伤口疼痛与年龄呈负相关（R=-0.18，P<0.05）。与手术部位、麻醉方式及手术时间具有显著相关性（P<0.05）。与性别、BMI、腹股沟疝分型、手术方式无显著相关性。经过性别、年龄和BMI校正，Logistic多因素分析结果显示麻醉方式是术后伤口疼痛的独立相关因素。

在局部麻醉加强化的麻醉方式下施行小切口无张力疝修补术，能有效减轻患者术后伤口早期疼痛感，有利于患者早期出院，对临床具有一定的参考意义。

To explore the related risk factors for pain in patients under open inguinal hernia repair.

A total of 188 patients with inguinal hernia from March 2016 to February 2018 were prospectively collected, who underwent surgical treatment in the general surgery department of China-Japan Friendship Hospital. All operations were performed by the same chief surgeon. The basic clinical information of patients was collected, and the numerical rating scale (NRS) was used to evaluate the pain of infusion puncture before the operation and the degree of wound pain at 6 h and 24 h after the operation. Pearson correlation analysis and Spearman rank correlation analysis were used for correlation analysis. Logistic regression analysis was used in multivariate analysis.

There was a negative correlation between pain scores at 6 h after surgery and age (R=-0.152, P<0.05). It was significantly correlated with the mode of anesthesia (R=0.164, P<0.05). There was no significant correlation with gender, body mass index (BMI), operation site, inguinal hernia classification, operation method and operation time. There was a negative correlation between pain scores at 24 hours after the operation and age (R=-0.18, P<0.05). It was significantly correlated with the surgical site, anesthesia methods, and operation time (P<0.05). There was no significant correlation with gender, BMI, inguinal hernia classification and operation mode. Multivariate analysis showed that anesthesia mode was an independent related factor of postoperative wound pain, after adjusted for gender, age, and BMI.

The combination of local and enhanced anesthesia for small incision tension-free hernia repair can effectively meliorate the early postoperative pain, which is conducive to the early discharge of patients, and has a certain reference significance for clinical practice.