成人腹股沟疝术后慢性疼痛研究

Research on chronic postherniorrhaphy inguinal pain in adults

目的:了解腹股沟疝术后疼痛的发生、发展及规范化镇痛管理方案,为临床合理用药提供参考。方法:通过阅读国内外近20年相关文献,对腹股沟疝修补术术后疼痛的性质、镇痛药物的选择、疼痛评估的现状及患者教育等方面进行总结归纳。结果:成人疝是不可自愈的,手术是唯一有效的治疗方法。无张力疝修补术后慢性疼痛高发生率已经成为不可忽视的问题,是术后主要的并发症之一,很大程度上影响了患者的术后恢复、生活质量及精神状态,已引起临床医师的广泛重视。结论:为了避免腹股沟疝修补术术后慢性疼痛的发生,除了通过严格规范手术操作过程,还应主要考虑规范的镇痛药物干预、合理的疼痛评估以及适当的患者教育,多学科协作共同改善术后慢性疼痛的发生。

Objective：To understand the occurrence, development and standardized management scheme of chronic postherniorrhaphy inguinal pain（CPIP）, and provide reference for rational drug use in clinical settings.Methods： By reviewing related literatures published worldwide in recent 20 years, the characteristics of CPIP, analgesic drug selection, the present situation of the pain evaluation and patients’ education after inguinal herniorrhaphy were summarized.Results： Adult hernia cannot be cured by itself, and the only effective therapy is surgery. CPIP has become one of the major complications of inguinal hernia repair surgery. Given the high incidence of CPIP, it cannot be neglected. It largely affected patient’s postoperative recovery, quality of life and mental state.Conclusion：To avoid the occurrence of chronic pain after inguinal hernia repair surgery, in addition to the strictly regulated process of our surgical procedures, the standardized analgesic drug intervention, rational pain evaluation after surgery and suitable patients’ education should also be considered. Multidisciplinary collaboration is in need to improve CPIP.