老年腹股沟疝修补术后慢性疼痛影响因素分析

Analysis of influencing factors of chronic pain after inguinal hernia repair in the elderly

目的研究老年腹股沟疝无张力修补术后慢性疼痛影响因素,以预防及减少慢性疼痛。方法回顾分析2018年1月—2019年1月张掖市山丹县人民医院收治的110例行无张力修补术治疗老年腹股沟疝患者资料,术后随访并统计慢性疼痛发生率。收集所有患者临床资料,分析发生慢性疼痛和未发生慢性疼痛患者的一般资料,采用logistic回归方程分析老年腹股沟疝无张力修补术后慢性疼痛影响因素。结果110例患者均给予腹股沟疝无张力修复术治疗,术后慢性疼痛发生率为23.64%(26/110);术后1 d、术后12个月疼痛程度比较差异有统计学意义(P<0.05);单因素分析:发生、未发生慢性疼痛者手术方式、麻醉方式、术中神经保护情况差异有统计学意义(P<0.05);多因素logistig回归分析显示:手术方式、麻醉方式、术中神经保护情况均为腹股沟疝无张力修补术后慢性疼痛影响因素。结论老年腹股沟疝无张力修补术后常并发慢性疼痛,明确其相关影响因素有助于采取针对性预防措施,以减少慢性疼痛发生。

Objective To study the influencing factors of chronic pain after tension-free inguinal hernia repair in the elderly,in order to prevent and reduce chronic pain.Methods A retrospective analysis was conducted on 110 elderly patients with inguinal hernia underwent tension-free repair in Shandan County People's Hospital of Zhangye City from January 2018 to January 2019,postoperative follow-up and statistics was conducted to calculate the incidence of chronic pain.The clinical data of all patients were collected,the general data of patients with and without chronic pain were analyzed,and the logistic regression equation was used to analyze the factors affecting chronic pain after tension-free inguinal hernia repair.Results A total of 110 patients were treated with tension-free repair of inguinal hernia,the incidence of postoperative chronic pain was 23.64(26/110);there was a statistically significant difference in pain levels between 1 day and 12 months after surgery(P<0.05).Univariate analysis:there were significant differences in surgical methods,anesthesia methods and intraoperative neuroprotection in patients with chronic pain and those without chronic pain(P<0.05);multivariate logistig regression analysis showed that operation and anesthesia methods and intraoperative neuroprotection were all factors affecting chronic pain after tension-free inguinal hernia repair.Conclusion Chronic pain often occured after tension-free repair of inguinal hernias in the elderly,and it was helpful to take preventive measures to reduce the occurrence of chronic pain by clarifying the related factors.