成人腹股沟疝修补术后慢性疼痛的原因分析

Causes of chronic pain after inguinal hernia repair in adults

腹股沟疝目前主要的治疗手段仍是手术,但术后的慢性疼痛又是不可避免的。腹股沟疝术后慢性疼痛的原因复杂,我们发现高龄、女性、术前的一些基础疾病、高体质量指数、不良的心理因素及患者术前较高的疼痛程度都是患者术后慢性疼痛的危险因素。术者对于术式、补片的选择及术者本身的操作水平也会对慢性疼痛的发生有一定影响。术后补片及切口的感染、术区血肿、术后的早期疼痛及感觉异常亦会导致慢性疼痛的发生。而对于疝类型、麻醉方式及补片固定方式对术后慢性疼痛的影响仍有待于进一步的临床研究。本文旨在总结归纳成人腹股沟疝术后慢性疼痛可能的原因。

Currently,the main treatment for inguinal hernia is still surgery,and chronic pain after hernia surgery is inevitable.The causes of chronic pain after inguinal hernia surgery are complex.We found that advanced age,female sex,some preoperative underlying diseases,high body mass index,adverse psychological factors and higher preoperative pain level are risk factors for postoperative chronic pain.The surgeon's choice of surgical method and mesh and the surgeon's operating level also have a certain impact on the occurrence of chronic pain.Postoperative infection of the mesh and incision,hematoma in the operative area,early postoperative pain and sensory abnormalities can also contribute to the development of chronic pain.Further clinical studies are needed to determine the effect of hernia type,anesthesia and mesh fixation on postoperative chronic pain.The purpose of this article is to summarize the possible causes of chronic pain after inguinal hernia surgery in adults.