摘要
目的探讨腹股沟疝Lichtenstein式无张力修补术后局部疼痛的原因及预防。方法对我院8年收治的448例各型腹股沟疝行Lichtenstein式无张力修补术病例的临床资料进行回顾性分析。结果共54例(12.1%,54/448)有不同程度的疼痛,其中Ⅱ度或以下疼痛为38例,Ⅲ度疼痛14例,Ⅳ度疼痛2例。中青年患者(<44.5岁)、复发疝再手术、局部浸润麻醉手术以及术中未保护或切断腹股沟神经的Lichtenstein式修补术后疼痛发生率和疼痛程度高于高龄患者(>44.5岁)、首次疝手术、椎管内麻醉以及术中保护腹股沟神经的患者,性别、疝类型、术前伴发疾病与否以及是否预防性使用抗生素对术后疼痛无明显影响。结论无张力疝修补术后局部疼痛大多数与挫伤、血肿、麻醉以及神经损伤有关。术中有效麻醉、精细操作、避免钝性分离、妥善止血以及保护神经可减少术后疼痛发生率以及降低疼痛程度。
Objective To investigate the cause and prevention of local pains after Lichtenstein tension-free procedures（LTFP） for inguinal hernias. Methods The clinical data of 448 cases with inguinal hernias undergoing LTFP were analyzed retrospectively. Results 54 cases（ 12.1% ） had local pains after operations,among which degree-Ⅱ or Ⅰ were 38 cases,degree-Ⅲ 14 cases and degrees-Ⅳ 2 cases. The ratio and severity of pains about young-middle age, recurrent hernias, under local infiltration anesthesia, and without inguinal nerves protection were more than that of older persons, first procedure, intraspinal anesthesia and with protection of inguinal nerves. There was no significant difference about gender, types of hernia, systemic diseases and prophylactic use of antibiotic for local pain after operation. Conclusion The local pains after LTFP are mostly relative with contusion,hematoma, anesthesia and injury of nerve. The effective anesthesia, subtle procedures, avoiding blunt dissection and protection of nerve are favorable to reduce ratio of pain and lessen severity of pains after LTFP for inguinal hernias.
出处
《中华全科医学》
2009年第5期476-477,共2页
Chinese Journal of General Practice
关键词
腹股沟疝
手术
疼痛
Inguinal hernia
Surgical procedures
Pain
