腹壁巨大切口疝修补术后早期疼痛的危险因素分析  

Analysis of risk factors for early postoperative pain after repair of giant incisional hernia of the abdominal wall

作　　者：陈传勤 张凯[2] 单世涵[2] 陶亮[2] 傅巧美[2] Chuanqin Chen;Kai Zhang;Shihan Shan;Liang Tao;Qiaomei Fu(Drum Tower Clinical Medical College of Jiangsu University,Nanjing 210008,China;Department of Colorectal Surgery,Drum Tower Hospital Affiliated to Nanjing University School of Medicine,Nanjing 210008,China)

机构地区：[1]江苏大学鼓楼临床医学院,南京210008 [2]南京大学医学院附属鼓楼医院结直肠外科,210008

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第2期178-183,共6页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探究腹壁巨大切口疝修补术术后早期疼痛发生的危险因素。方法收集2018年1月至2021年12月,于南京大学医学院附属鼓楼医院结直肠外科疝与腹壁专业组接受腹壁巨大切口疝修补术的252例患者的临床资料。采用视觉模拟评分法(VAS)对患者术后疼痛程度进行评分,据是否发生术后早期疼痛,分为观察组(术后3 d内,VAS评分≥4分)与对照组(术后3 d内,VAS评分<4分)。对可能引起患者早期术后疼痛的因素行单因素分析,对单因素分析中有统计学意义的因素进一步行logistic多因素回归分析,探索引起术后早期疼痛的独立危险因素。结果接受腹壁巨大切口疝修补术的252例患者中有32例(12.70%)发生术后早期疼痛。2组患者年龄、术前白细胞计数、术前白蛋白、原发性高血压、饮酒史、术后便秘情况比较,差异均有统计学意义(P<0.1)。单因素分析结果显示,年龄(OR=0.962,P=0.009)、术前白蛋白(OR=0.831,P<0.001)、原发性高血压(OR=0.162,P=0.001)与术后早期疼痛有关。进一步行多因素logistic回归分析显示:年龄(OR=0.963,P=0.033),术前白蛋白(OR=0.780,P<0.001),原发性高血压(OR=0.100,P=0.001),术后便秘(OR=4.340,P=0.018)是术后早期疼痛的独立影响因素。结论年龄低、术前白蛋白低、无原发性高血压和术后便秘是术后早期疼痛的独立危险因素,对于行腹壁巨大切口疝修补术的患者,存在术后早期疼痛高危险因素的可及时采取干预措施,预防和治疗术后早期疼痛。Objective To investigate the risk factors for early postoperative pain following giant incisional hernia repair of the abdominal wall.Methods Clinical data of 252 patients who underwent giant incisional hernia repair in the Hernia and Abdominal Wall Specialty Group of the Department of Colorectal Surgery,Drum Tower Hospital Affiliated to Nanjing University School of Medicine,from January 2018 to December 2021,were collected.The Visual Analogue Scale(VAS)was utilized to assess the intensity of postoperative pain.Based on the occurrence of early postoperative pain,patients were divided into the observation group(VAS score≥4 within 3 days post-surgery)and the control group(VAS score<4 within 3 days post-surgery).Univariate analysis was conducted on factors potentially causing early postoperative pain.Factors significant in the univariate analysis were further analyzed using logistic multivariate regression to identify independent influencing factors for early postoperative pain.Results Early postoperative pain occurred in 32 patients(12.70%)of the 252 patients who underwent repair of large incisional hernia.Significant differences were found between the two groups in terms of age,preoperative white blood cell count,preoperative albumin,primary hypertension,history of alcohol consumption,and postoperative constipation(P<0.1).Univariate analysis indicated that age(OR=0.962,P=0.009),preoperative albumin(OR=0.831,P<0.001),and primary hypertension(OR=0.162,P=0.001)were related to early postoperative pain.Further multivariate logistic regression analysis revealed that age(OR=0.963,P=0.033),preoperative albumin(OR=0.780,P<0.001),primary hypertension(OR=0.100,P=0.001),and postoperative constipation(OR=4.340,P=0.018)were independent influencing factors for early postoperative pain.Conclusion Low age,low preoperative albumin levels,no primary hypertension,and postoperative constipation are independent risk factors for early postoperative pain.For patients undergoing giant incisional hernia repair of the abdominal wall,timel

关 键 词：切口疝 疝修补术 术后疼痛 危险因素 

分 类 号：R656.2[医药卫生—外科学]