腹股沟疝术后慢性疼痛发生情况及其神经因素分析  

Analysis of chronic pain after inguinal hernia operation and its neurological factors

作　　者：吴国龙 丁云飞 郭丙坤 王腾驰 余同辉 WU Guolong;DING Yunfei;GUO Bingkun;WANG Tengchi;YU Tonghui(Department of General Surgery,902 Hospital of PLA Joint Logistic Support Force,Bengbu,Anhui 233000,China)

机构地区：[1]解放军联勤保障部队第九〇二医院普外科,安徽蚌埠233000

出　　处：《临床外科杂志》2025年第2期171-174,共4页Journal of Clinical Surgery

摘　　要：目的 探讨腹股沟疝术后慢性疼痛发生情况及其早期神经预测因素。方法 2018年8月~2023年5月收治的腹股沟疝手术病人400例,根据术后是否出现慢性疼痛分为慢性疼痛组和非慢性疼痛组。采用采用Lasso-Logistic回归分析腹股沟疝术后急慢性疼痛发生的预测因素。结果 37例病人术后疼痛持续时间超过3个月,为慢性疼痛组,其余363例病人为非慢性疼痛组。单因素分析显示,慢性疼痛组年龄、体质量指数(BMI)、吸烟史、术前腹股沟疼痛、术中牵拉或损伤神经、伤口感染和术后急性疼痛与非慢性疼痛组比较,差异有统计学意义(P<0.05)。Lasso回归对数据进行正则化处理,筛选出术前腹股沟疼痛、术中牵拉或损伤神经、术后急性疼痛3个是影响术后慢性疼痛的危险因素。多因素Logistic回归分析显示,术前腹股沟疼痛(OR=2.548,95%CI 1.150~5.647)、术中牵拉或损伤神经(OR=4.435,95%CI2.084~9.436)和术后急性疼痛(OR=2.242,95%CI1.041~4.829)是术后慢性疼痛的影响因素(P<0.05)。结论 术前腹股沟区疼痛、术中牵拉或损伤神经、术后急性疼痛是腹股沟疝术后慢性疼痛的影响因素,识别高危人群并予以针对性措施有助于防治术后慢性疼痛。Objective To investigate the predictors of chronic pain after inguinal hernia surgery.Methods A total of 400 patients with inguinal hernia surgery in our hospital from August 2018 to May 2023 were selected as the study objects.Visual analog scoring(VSA)was used to evaluate postoperative acute pain within 24 h after surgery.The patients were divided into chronic pain group and non-chronic pain group according to whether chronic pain occurred after surgery.Thirty-seven patients with postoperative pain lasting more than 3 months were in the chronic pain group,and the remaining 363 patients were in the non-chronic pain group.Lasso-Logistic regression was used to analyze the predictors of acute and chronic pain after inguinal hernia surgery.Results Univariate analysis showed that there were significant differences in age,BMI,smoking history,preoperative groin pain,intraoperative nerve tension or injury,wound infection and postoperative acute pain between the chronic pain group and the non-chronic pain group(P<0.05).The data were regularized by Lasso regression,and three representative risk factors of chronic postoperative pain,namely preoperative groin pain,intraoperative nerve pulling or injury,and postoperative acute pain,were selected.Multivariate Logistic regression analysis showed that:Preoperative groin pain(OR=2.548,95%CI 1.150-5.647),intraoperative nerve tension OR injury(OR=4.435,95%CI 2.084-9.436)and postoperative acute pain(OR=2.242,95%CI 1.041-4.829)was the factor of chronic pain after operation(P<0.05).Conclusion Preoperative groin pain,intraoperative nerve pulling or injury,and postoperative acute pain are the factors affecting chronic pain after inguinal hernia.Identifying high-risk groups and taking targeted measures are helpful to prevent and treat chronic pain after inguinal hernia.

关 键 词：腹股沟疝 手术 慢性疼痛 预测 

分 类 号：R47[医药卫生—护理学]