腹股沟疝术后顽固性疼痛的处理

Treatment of Refractory Pain after Groin Hernia Repair

探讨疝修补术后顽固性疼痛的原因和手术治疗方式。方法:分析1998～2001年我院收治的8例腹股沟疝修补术后疼痛病人的临床资料,结合文献进行讨论。结果:1例病人经神经阻滞治疗后缓解;2例行单纯神经松解,2例行痛点局部疤痕切除,1例行翻转无张力补片部分修剪,2例行髂前上棘内侧髂腹股沟、髂腹下神经部分切除,术后疼痛均缓解。结论:疝修补术后出现顽固性疼痛的常见原因为神经被缝扎或补片移位压迫或被纤维粘连牵扯等;手术方式应个体化,结合术前疼痛特点及术中探查情况,合理选择神经松解、疤痕切除、翻转补片部分修剪及神经切除等方式,可避免盲目切除神经带来的严重后果和疝的复发。

Objecitve:To discuss the cause of refractory pain after groin hernia repair and its appropriate surgical management.Methods:The clinical data of8patients admitted between 1998 and 2001 for pain after groin hernia repair were ana lyzed and discussed with review of literature.Results:The modes of treatment were local nerve blocking in1case,neu rolysis in 2 cases,scar excision in 2 cases,shearing of portion of twisted mesh in1case,partial resection of ilioinguinal nerve and iliohypastric nerve in 2 cases.All cases were relieved from their symptoms.Conclusions:The causes of re fractory pain after groin hernia repair are multiple.The operation to be proposed should be individualized according to the characteristics and the cause of pain.