夏云展，解寒冰，李琼，孙德利.河南省郑州人民医院普通外科一病区，河南郑州　450003；.河南省郑州人民医院神经内科，河南郑州　450003

腹膜前技术腹股沟疝无张力修补术后慢性疼痛诊治

夏云展1，解寒冰1，李琼2，孙德利1
1.河南省郑州人民医院普通外科一病区，河南郑州450003；2.河南省郑州人民医院神经内科，河南郑州450003

目的探讨腹膜前技术腹股沟疝无张力修补术后慢性疼痛的原因与治疗方法。方法2008年1月—2015 年12月郑州人民医院普通外科共有680例实施腹膜前腹股沟疝无张力修补术病例随访，慢性疼痛21例，探讨发生原因及处理措施。依据疼痛处理前后进行分组，疼痛处理前组21例和疼痛处理后组21例，止痛药物治疗、物理治疗、神经阻滞。观察两组腹股沟疝无张力修补术患者疼痛分级、生活质量评分情况。结果疼痛处理后组疼痛分级1级（57.1%）、2级（42.9%）、3级（0）优于疼痛处理前组1级（19.0%）、2级（66.7%）、3级（14.3%），疼痛处理后组患者生活质量评分（82.8±11.7）分均高于疼痛处理前组（70.5±10.2）分，P＜0.05，差异均有统计学意义。结论腹膜前无张力疝修补术后慢性疼痛原因多样，药物、理疗和封闭治疗可解除疼痛。保守无效考虑取出补片。

腹股沟疝；无张力疝修补术；慢性疼痛

［Abstract］Objective To investigate the causes and treatment of chronic pain after inguinal hernia repair without tension.Methods The 680 cases of patients with abdominal inguinal hernia repair were followed up in general surgery department of Zhengzhou people's Hospital from January 2008 to December 2015，21 cases were chronic pain，and the causes and treatment measures were application.Which was to be divided into two groups，before pain management group 21 cases and after pain management group 21 cases，painkillers treatment、physics treatment、nerve block.The pain grading、living quality score of two group tension free repair of inguinal hernia patients were detected.Results The pain grading after pain management group 1 grade（57.1%）、2 grade（42.9%）、3 grade（0）were better than before pain management group 1 grade（19.0%）、2 grade（66.7%）、3 grade（14.3%），the QOL after pain management group（82.8± 11.7）score were better than before pain management group（70.5±10.2）score，P＜0.05，the difference were statistical significance.Conclusion The causes of chronic pain after tension free hernia repair are various，and the medicine，physical therapy and closed therapy can relieve the pain.Conservative invalid consider taking out patch.

［Key words］Inguinal hernia；Tension-free hernioplasty；Chronic pain

腹股沟疝是一种老年人常见疾病，随着年龄的增长发病率明显升高，手术是唯一治疗腹股沟疝的有效方法，腹股沟疝无张力修补术为成人疝修补金标准。腹膜前技术腹股沟疝无张力修补技术基于耻骨肌孔理论，这种手术方式明显降低腹股沟疝的复发率，但是对于术后慢性疼痛依旧无法避免。……