中国普外基础与临床杂志

中国普外基础与临床杂志

腹腔镜腹股沟疝修补术后慢性疼痛的临床特征及危险因素分析

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目的 探讨腹腔镜腹股沟疝修补术后慢性疼痛的临床特征及危险因素。 方法 回顾性分析 2013 年 1 月至 2017 年 12 月期间厦门医学院附属第二医院普外肝胆外科完成的 142 例行腹腔镜腹股沟疝修补术患者的临床和随访资料。 结果 本组患者行腹腔镜腹股沟疝修补术后慢性疼痛的发生率为 12.7%(18/142),其中 83.3%(15/18)的患者的疼痛部位位于腹股沟区。单因素分析结果表明,接受标准量型补片、大号补片、机械性固定补片及术后并发症者的术后慢性疼痛发生率高(P<0.05)。多因素分析结果表明,大号补片 [OR=1.82,95% CI 为(1.18,5.36),P=0.023]、机械性固定补片 [OR=1.44,95% CI 为(1.07,3.62),P=0.039] 及术后发生并发症 [OR=2.53,95% CI(1.27,7.31),P=0.011] 是术后慢性疼痛的独立危险因素(P<0.05)。 结论 腹腔镜腹股沟疝修补术后慢性疼痛的发生是多种因素共同作用的结果,尤其是与并发症及补片因素有关。

Objective To investigate the clinical characteristics and risk factors of chronic pain after laparoscopic inguinal hernia repair. Methods The clinical data of 142 cases underwent laparoscopic inguinal hernia repair from January 2013 to December 2017 in The Second Affiliated Hospital of Xiamen Medical College were retrospectively analyzed. Results The incidence of chronic pain after laparoscopic inguinal hernia repair was 12.7% (18/142), and 83.3% (15/18) of the patients were located in the inguinal region. Univariate analysis showed that postoperative chronic pain rates were higher in patients receiving standard patch, large patch, mechanical fixation patch, and with postoperative complications (P<0.05). Multivariate analysis showed that large patch [OR=1.82, 95% CI was (1.18, 5.36), P=0.023], mechanical fixation patch [OR=1.44, 95% CI was (1.07, 3.62), P=0.039], and postoperative complications [OR=2.53, 95% CI was (1.27, 7.31), P=0.011] were independent risk factors for postoperative chronic pain after laparoscopic inguinal hernia repair. Conclusion The occurrence of chronic pain after laparoscopic inguinal hernia repair is the result of many factors, especially the complications and patch factors.

关键词: 慢性疼痛; 腹股沟疝; 经腹腔腹膜前疝修补术; 完全腹膜外疝修补术; 腹腔镜

Key words: chronic pain; inguinal hernia; transperitoneal preperitoneal hernia repair; totally extraperitoneal hernia repair; laparoscopy

引用本文: 严辉弟, 周立新, 王茂林, 林培艺, 苏继钦. 腹腔镜腹股沟疝修补术后慢性疼痛的临床特征及危险因素分析. 中国普外基础与临床杂志, 2019, 26(2): 180-184. doi: 10.7507/1007-9424.201810040 复制

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