腹腔镜经腹腹膜前腹股沟疝修补术的术后疼痛分析

The analysis of pain after laparoscopic transabdominal preperitoneal hernia repair for inguinal hernia

目的:探讨腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)治疗腹股沟疝术后疼痛的原因及治疗方法。方法:回顾分析2009年5月至2015年2月为1 036例患者行TAPP的临床资料,总结分析患者年龄、手术时期、钉枪固定等指标。结果:1 036例均顺利完成TAPP,无一例中转开腹。术后发生疼痛89例,发生率8.6%。不同手术时期、应用钉枪钉合与免钉合术后疼痛差异有统计学意义(P<0.05)。不同年龄、U形钉与螺旋钉固定TAPP术后疼痛差异无统计学意义(P>0.05)。结论:手术标准化是减少或避免TAPP术后疼痛的根本方法,必要的心理安慰、合适的治疗方式是治疗的关键。

Objective：To investigate the causes and treatments of pain after laparoscopic transabdominal preperitoneal hernia repair （TAPP） for inguinal hernia. Methods：The clinical data of 1 036 patients with inguinal hernia who underwent TAPP from May 2009 to Feb. 2015 were collected and retrospectively analyzed according to patients＇ age, operative period, the situation of nail gun fixation and so on. Results：All operations were performed successfully without conversion to open surgery. The postoperative pain occurred in 89 cases （g. 6% ）. The incidence of the postoperative pain was different between different operation period and between nail gun group and non stapling group （ P 〈 0.05 ）. There was no significant difference between patients aged 35-50 years and those more than 50 years, and between U nail group and spiral nail fixation group. Conclusions：The standardized operation is the key to reduce or avoid the pain after TAPP. Necessary psychological comfort and treatment are also very important for the treatment of postoperative pain.