CAJ | 학술논문

目的：探讨腹股沟疝无张力修补术后慢性疼痛与周围神经的关系。方法2012年6月至2013年12月郑州大学第一附属医院对200例腹股沟疝患者行无张力修补术,术中注意保护神经,术后进行3、6、12个月3次随访。结果本组患者术后进行3次随访,术后3个月慢性疼痛为16例,发生率8.0%,其中轻度疼痛为12例,占75.0%,中度疼痛为4例,占25.0%；术后6个月为8例,发生率4.0%,其中轻度疼痛为6例,占75.0%,中度疼痛为2例,占25.0%；术后12个月为6例,发生率3.0%,其中轻度疼痛为5例,占83.3%,中度疼痛为1例,占16.7%。3次随访均无重度疼痛发生。术后6个月慢性疼痛发生率与 Reinpol 的16.5%(116/704)和 Alfieri 的9.7%(94/973)研究结果比较,差异均有统计学意义(Reinpol P=0.000,Alfieri P=0.010)。结论腹股沟疝无张力修补术后慢性疼痛的发生与术中损伤周围神经密切相关；术中注意保护神经,避免过度分离、牵拉、卡压、缝扎及补片边缘压迫、切割神经等,是降低术后慢性疼痛的有效措施。
목적：탐토복고구산무장력수보술후만성동통여주위신경적관계。방법2012년6월지2013년12월정주대학제일부속의원대200례복고구산환자행무장력수보술,술중주의보호신경,술후진행3、6、12개월3차수방。결과본조환자술후진행3차수방,술후3개월만성동통위16례,발생솔8.0%,기중경도동통위12례,점75.0%,중도동통위4례,점25.0%；술후6개월위8례,발생솔4.0%,기중경도동통위6례,점75.0%,중도동통위2례,점25.0%；술후12개월위6례,발생솔3.0%,기중경도동통위5례,점83.3%,중도동통위1례,점16.7%。3차수방균무중도동통발생。술후6개월만성동통발생솔여 Reinpol 적16.5%(116/704)화 Alfieri 적9.7%(94/973)연구결과비교,차이균유통계학의의(Reinpol P=0.000,Alfieri P=0.010)。결론복고구산무장력수보술후만성동통적발생여술중손상주위신경밀절상관；술중주의보호신경,피면과도분리、견랍、잡압、봉찰급보편변연압박、절할신경등,시강저술후만성동통적유효조시。
Objective To investigate the relationship between peripheral nerves and chronic pain following inguinal hernia tension-free repair. Methods 200 patients with inguinal hernia were performed with tension-free repair in the First Affiliated Hospital of Zhengzhou University from June 2012 to December 2013. The nerves were protected during operation and patients were followed up at 3 months, 6 months and 1 year after operation. Results At 3 months after surgery, the incidence rate of chronic pain was 8. 0%(16 / 200), mild pain accounted for 75. 0% (12 / 16) and moderate pain accounted for 25. 0% (4 / 16). At 6 months after operation, we found that chronic pain rate was 4. 0% (8 / 200), mild pain accounted for 75. 0% (6 / 8) and moderate pain accounted for 25. 0% (2 / 8). The third follow-up (1 year) indicated the incidence of chronic pain was 3. 0% (6 / 200), mild pain accounted for 83. 3% (5 / 6) and moderate pain accounted for 16. 7% (1 / 6). No severe pain occurred during follow-up. The incidence rate at 6 months of follow-up was significantly lower than Reinpol and Alfieri's study ( Reinpol 16. 5% , P = 0. 000; Alfieri 9. 7% , P= 0. 010; respectively). Conclusion Peripheral nerve injury is an important cause of chronic pain after inguinal hernia repair. Protecting the nerves and avoiding entrapment, ligation and compression of nerves are effective measures for reducing postoperative chronic pain.