腹股沟疝修补术切口浸润对术后疼痛并发症影响.docVIP

腹股沟疝修补术切口浸润对术后疼痛并发症影响 　　【摘要】 目的探讨切口浸润对腹股沟疝修补术术后疼痛并发症的影响。方法将我院2007年1月至2009年12月收治的腹股沟疝病例264例按随机数字表法分为术后切口浸润组和对照组,手术方法均采用充填式无张力疝修补,实验组在手术结束时给予0.5%20 ml左旋布比卡因切口局部浸润,对照组给予20ml生理盐水,两组患者术后随访三月,观察其术后慢性疼痛的发生情况。结果切口浸润组和对照组的术后伤口并发症发生率比较,差异均无统计学意义( P 0. 05);术后早期疼痛发生率、麻醉并发症(恶心/呕吐)及慢性疼痛发生率,切口浸润组均明显低于对照组,两组差异有统计学意义( P 0. 05)。结论术后切口浸润对腹股沟疝修补术术后疼痛的预防具有积极意义。 　　【关键词】腹股沟疝修补 切口浸润 术后疼痛 　　 　　【中图分类号】R656.2+1【文献标识码】 A 【文章编号】1005-0515(2010)005-003-03 　　Investigating the effect of intra-operative infiltration on post-operative pain after inguinal hernia repair。 　　AbstractObjectiveTo investigate the effect of intra-operative infiltration on post-operative pain after inguinal hernia repair.MethodsA total of 132 inguinal hernia cases from 2007 to 2009 were allocated and randomly divided into the intra-operative infiltration group( Group I ) and placebo group(Group II). Patients in Group I receive a local injection of 20 ml Carbostesin 0.5% at the end of the operation according to a standardised procedure. Group II patients get a 20 ml placebo (0.9% Saline) injection. Patient in two groups had finished their 3-months follow-up to allow for study of the complications of post-operative pain. ResultsIt was found that the occurrence of postoperative pain and the anesthetic complications in intra-operative infiltration group were significantly less than those in the placebo of group ( P 0. 05) .ConclusionsIntra-operative infiltration has a positive effect on the prevention of post-operative pain after inguinal hernia repair. 　　Key wordsInguinal hernia repairIntra-operative infiltrationpost-operative pain 　　 　　临床上无张力疝修补术的推广应用,使腹股沟区疝的术后复发率明显降低,但术后腹股沟区疼痛已成为影响患者术后生活质量的突出问题。腹股沟疝术后的慢性疼痛发生较疝的复发更为常见(张力性修补复发率10%~15%之间,无张力修补复发率1%),临床上常常只重视复发问题,而忽视此种并发症[1~4]。为此各国疝外科学家曾多次尝试改进手术方法,但效果一般。近年来,国外部分学者用麻醉剂术后切口浸润,结果证明对于术后早期急性疼痛的预防有积极意义[5~6]。本研究旨在探讨切口浸润对腹股沟疝修补术术后慢性疼痛的影响及意义。 　　1 资料与方法 　　1.1 临床资料以2007年1月至2009年12月我院收治的腹股沟疝患者入组,入组标准为单侧疝和初发疝,滑疝和急性嵌顿疝不进入本研究。共264例,经患者本人同意,采用数字表法随机分为术后切口浸润组(实验组)和对照组各132例,两组在性别构成比、平