摘要
目的：探讨腹股沟疝日间手术后早期切口疼痛的影响因素。方法回顾性分析2006年5月至2013年4月，首都医科大学宣武医院就诊并接受疝日间手术患者1221例临床资料。依据术后24 h切口疼痛的VAS评分将患者分为轻度疼痛组（VAS≤3分）及中、重度疼痛组（VAS＞3分）。术后早期切口疼痛的独立危险因素采用单因素Logistic回归分析。结果年龄≥40岁中、重疼痛发生率为8．1％，年龄＜40岁为38．8％，二组比较差异有统计学意义（χ2＝129．3，P＝0．000）。BMI指数≥22中、重疼痛发生率为9．9％，BMI指数＜22为18．4％，二组比较差异有统计学意义（χ2＝17．1，P＝0．000）。吸烟患者较未吸烟者中、重疼痛发生率高，二组比较差异有统计学意义（χ2＝4．1， P＝0．044）。局部麻醉药（0．5％利多卡因）用量≥50 ml 较用量＜50 ml 中、重疼痛发生率高（χ2＝14．2，P＝0．000）。未采取术后镇痛较采取术后镇痛中、重疼痛发生率高（χ2＝177．2，P＝0．000）。单因素Logistic回归分析发现，患者年龄≥40岁[OR（95％CI）＝0．2（0．1～0．3），P＝0．000]、BMI指数≥22[OR（95％CI）＝0．6（0．4～0．7），P＝0．001]、术中麻醉药用量≥50 ml[OR（95％CI）＝1．6（1．2～2．0），P＝0．011]及未采取术后镇痛[OR（95％CI）＝0．1（0．0～0．2），P＝0．000]是发生术后早期切口中、重疼痛的独立危险因素。结论疝日间手术后早期切口疼痛，患者年龄、BMI指数、术中麻醉药用量及是否采用术后镇痛与中、重度切口疼痛的发生具有相关性。
Objective To determine the risk factors of early postoperative pain after surgical repair of inguinal hernia.Methods The medical records of patients who received surgical repair of inguinal hernia in daytime and admitted to our department between May 2006 and April 201 3 were respectively analyzed.The patients were divided into two groups according to the VAS score 24h after operation.Logistic regression was performed to determine the independent risk factors for early postoperative pain.Results A total of 1 221 patients were included in our study.Chi-square analysis showed that the incidence of moderate and severe postoperative pain was significantly different between older and younger patients（8.1% vs 38.8%,χ2 =129.3,P=0.000）,those patients with higher and lower BMI（9.9% vs 18.4%,χ2 =17.1,P=0.000）,and smokers and non-smokers（1 4.5% vs 1 0.6%,χ2 =4.1 ,P=0.044）.Patients who used more introperative anesthetic（17.8% vs 10.1%,χ2 =14.2,P =0.000）and without postoperative analgesia （1 2.4% vs 2.1%,χ2 =1 77.2,P=0.000）were more likely to suffer moderate and severe postoperative pain.Results of logistic regression showed that age≥40 years,BMI≥22,introperative anesthetic≥50 ml and no postoperative analgesia were the independent risk factors for early postoperative pain.Conclusions Early postoperative pain is a crucial problem.Age,BMI index,intraoperative anesthetic dosage and usage of postoperative analgesia were significantly associated with the occurrence of moderate and severe postoperative pain.
出处
《中华疝和腹壁外科杂志（电子版）》
2014年第2期7-9,共3页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
腹股沟
日间住院医疗
外科手术
疼痛
手术后
Hernia,inguinal
Day care
Surgical procedures,operative
Pain,postoperative
