腹股沟疝无张力修补术后慢性疼痛与周围神经的关系  

The relationship between peripheral nerves and chronic pain after tension-free repair of inguinal hernia

作　　者：蒋亚男[1] 陈健民[1] 王殿琛[1] 陈亚柯[1] 李伟杰[1] 

机构地区：[1]郑州大学第一附属医院疝和腹壁外科,450052

出　　处：《中华疝和腹壁外科杂志（电子版）》2015年第3期40-42,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨腹股沟疝无张力修补术后慢性疼痛与周围神经的关系。方法 2012年6月至2013年12月郑州大学第一附属医院对200例腹股沟疝患者行无张力修补术,术中注意保护神经,术后进行3、6、12个月3次随访。结果本组患者术后进行3次随访,术后3个月慢性疼痛为16例,发生率8.0%,其中轻度疼痛为12例,占75.0%,中度疼痛为4例,占25.0%;术后6个月为8例,发生率4.0%,其中轻度疼痛为6例,占75.0%,中度疼痛为2例,占25.0%;术后12个月为6例,发生率3.0%,其中轻度疼痛为5例,占83.3%,中度疼痛为1例,占16.7%。3次随访均无重度疼痛发生。术后6个月慢性疼痛发生率与Reinpol的16.5%(116/704)和Alfieri的9.7%(94/973)研究结果比较,差异均有统计学意义(Reinpol P=0.000,Alfieri P=0.010)。结论腹股沟疝无张力修补术后慢性疼痛的发生与术中损伤周围神经密切相关;术中注意保护神经,避免过度分离、牵拉、卡压、缝扎及补片边缘压迫、切割神经等,是降低术后慢性疼痛的有效措施。Objective To investigate the relationship between peripheral nerves and chronic pain following inguinal hernia tension-free repair. Methods 200 patients with inguinal hernia were performed with tension-free repair in the First Affiliated Hospital of Zhengzhou University from June 2012 to December2013. The nerves were protected during operation and patients were followed up at 3 months,6 months and1 year after operation. Results At 3 months after surgery,the incidence rate of chronic pain was 8. 0%（ 16 /200）,mild pain accounted for 75. 0%（ 12 /16） and moderate pain accounted for 25. 0%（ 4 /16）. At6 months after operation,we found that chronic pain rate was 4. 0%（ 8 /200）,mild pain accounted for75. 0%（ 6 /8） and moderate pain accounted for 25. 0%（ 2 /8）. The third follow-up（ 1 year） indicated the incidence of chronic pain was 3. 0%（ 6 /200）,mild pain accounted for 83. 3%（ 5 /6） and moderate pain accounted for 16. 7%（ 1 /6）. No severe pain occurred during follow-up. The incidence rate at 6 months of follow-up was significantly lower than Reinpol and Alfieri ＇s study（ Reinpol 16. 5%,P = 0. 000; Alfieri9. 7%,P = 0. 010; respectively）. Conclusion Peripheral nerve injury is an important cause of chronic pain after inguinal hernia repair. Protecting the nerves and avoiding entrapment,ligation and compression of nerves are effective measures for reducing postoperative chronic pain.

关 键 词：疝 腹股沟 疝 修补术 慢性疼痛 神经 

分 类 号：R656.21[医药卫生—外科学]