摘要
目的 分析手术方式及补片材质对腹股沟疝术后慢性疼痛的影响.方法 收集2013年1月至2016年1月于南安市医院行开放性腹股沟疝无张力修补术的患者536例,手术方式为改良Kugel术、Lichtenstein术、Milikan术及UHS术.术后随访,对存在慢性疼痛的患者进行分析,探讨手术方式和补片材质对慢性疼痛的影响.结果 536例患者中,行改良Kugel术157例,Lichtenstein术122例,Milikan术158例,UHS术99例;术后共有111例患者存在不同程度的术后慢性疼痛,慢性疼痛发生率为20.7％;其中改良Kugel术为33.8％（53/157）,Lichten-stein术为14.8％（18/122）,Milikan术为15.8％（25/158）,UHS术为15.2％（15/99）,改良Kugel术慢性疼痛的发生率高于Lichtenstein、Milikan和UHS术,差异有统计学意义（P〈0.05）;Lichtenstein、Milikan、UHS术之间慢性疼痛发生率比较差异均未见统计学意义（P均〉0.05）.轻量型补片共379例（Lichtenstein、Milikan、UHS术）,术后慢性疼痛发生率为15.3％（58/379）;重量型补片共157例（改良Kugel）,术后慢性疼痛发生率为33.8％（53/157）,差异有统计学意义（P〈0.05）.结论 开放性腹股沟疝术后慢性疼痛是常见的并发症,改良Kugel术比Lichtenstein、Milikan和UHS术有更高的术后慢性疼痛发生率,轻量型补片比重量型补片有较少的术后慢性疼痛发生率,补片材质可能和改良Kugel术后较高的慢性疼痛发生率有关.
Objective To analyze the effects of operative method and patch material on chronic pain after inguinal hernia surgery .Methods A total of 536 patients who underwent open tension-free herniorrhaphy in the Hospital of Nan ＇an City from January 2013 to January 2016 were collected .The operation methods included modified Kugel operation , Lichtenstein operation , Milikan operation and UHS operation.Patients were followed up after surgery and the patients who had chronic pain were analyzed to investigate the influence of surgical methods and patch materials on chronic pain .Results Among the 536 patients, 157 cases underwent modified Kugel operation , 122 cases were treated by Lichtenstein operation, 158 cases were treated by Milikan operation and 99 cases were treated by UHS operation . There were 111 cases of postoperative chronic pain after operation , the incidence of chronic pain was 24.4%, of which 33.8%（ 53/157 ） presented in modified Kugel operation , 14.8%（ 18/122 ） was caused by Lichtenstein operation , 5.8%（25/158） presented in Milikan operation and 15.2%（15/99） occurred in UHS operation , the incidence of chronic pain in modified Kugel was higher than that in Lichtenstein , Milikan and UHS operation （ P〈0.05 ）; and there was no significant difference in incidence of chronic pain among Lichtenstein , Milikan and UHS operation （all P〉0.05）.A total of 379 cases （ Lichtenstein, Milikan, UHS operation ） were treated with lightweight patch , the incidence of chronic pain after lightweight patch operation was 15.3%（ 58/379 ）; a total of 157 cases were treated with weight-type patch （ modified Kugel operation ） , the incidence of chronic pain after operation was 33.8%（53/157）;the difference in incidence of chronic pain was statistically significant between the two kinds of patch （ P〈0.05 ） .Conclusions Chronic pain is a common complication after open inguinal hernia operation .Modified Kugel surgery has a higher incidence of chronic pain than Lichtenstein , Milikan and UHS operation .Lightweight patch has less incidence of chronic pain than weight -type patch , and material of the patch may be the factor to the higher incidence of chronic pain after the Modified Kugel .
作者
陈志山
洪黎清
杨昌毅
傅少龙
黄思宝
周方超
肖凯阳
Chen Zhishan;Hong Liqing;Yang Changyi;Fu Shaolong;Huang Sibao;Zhou Fangchao;Xiao Kaiyang(Department of Minimally Invasive Surgery,the Hospital of Nan＇an City,Nan＇an 362300,China)
出处
《中国实用医刊》
2018年第17期86-88,共3页
Chinese Journal of Practical Medicine
关键词
慢性疼痛
腹股沟疝
无张力疝修补术
Chronic pain
Inguinal hernia
Tension-free herniorrhaphy
