腹壁疝修补术后疼痛预防及处理

Causes and management of chronic pain after hernia repair

疝修补术后疼痛是严重影响手术效果和病人生活质量的并发症。影响疼痛的因素有疝修补术中神经损伤、补片周围组织增生对神经的卡压、补片固定方法以及病人的体质差异等。预防疝修补术后发生疼痛须注意手术规范化操作,熟悉腹股沟区及腹壁神经解剖,合理选择补片,减少纤维结缔组织过度增生,并适当固定补片。疼痛发生后应及时进行干预,包括给予止痛药物、局部神经封闭、脊神经阻滞等非手术治疗方法。对于非手术治疗无效的顽固性疼痛,经过慎重评估后可再手术取出补片,并切除补片周围受损伤的神经,以缓解疼痛。

Postoperative pain is a complication that seriously affects the effect of surgery and the quality of life of patients.The causes of pain include nerve damage in hernia repair surgery,the card pressure on nerves during the process of adding value to the tissues around the patch,the method of fixing the mesh and the difference of the patient’s individual physique.Preventing the occurrence of postoperative pain needs to pay attention to the normal operation of surgery,familiar with the groin area and abdominal wall nerve anatomy to avoid damage,reasonable choice of hernia mesh to reduce the hyper plorofing of fibrous connective tissue and properly fixed the mesh.After the pain,the timely intervention,including painkillers,local nerve closure,spinal nerve block and other non-surgical treatment.For non-surgically ineffective stubborn pain,after careful evaluation,surgeons may remove the mesh and remove the damaged nerves around the mesh in order to relieve the pain.