de Lange D H, Wijsmuller A R, Aufenacker T J, Rauwerda J A, Simons M P
VU Medisch Centrum, afd. Heelkunde, Amsterdam.
Ned Tijdschr Geneeskd. 2008 Oct 11;152(41):2205-9.
Two male patients, aged 37 and 56, suffered from neuralgic pain after a Lichtenstein procedure for inguinal hernia repair using prosthetic reinforcement. Since mesh-based repair techniques have decreased the recurrence rate, postoperative inguinal pain has become a major complication of these operations. Three months after surgery, 20% of the patients experience some pain. In 12% of the patients this pain limits daily activities and 1-3% of the patients are invalidated by neuralgic pain. Preventing damage to sensory nerves during the operation is one way of preventing neuralgic pain. Damaged sensory nerves should be excised. Neuralgic pain after the operation may be alleviated by tricyclic antidepressants, opioids or antiepileptic drugs. In selected patients with neuralgic pain neurectomy is indicated. In one of the patients presented the neuralgic pain disappeared after neurectomy of the ilioinguinal nerve. Triple neurectomy in the other patient, however, was unsuccessful.
两名男性患者，年龄分别为37岁和56岁，在采用人工补片加强的Lichtenstein手术修复腹股沟疝后出现神经痛。由于基于补片的修复技术降低了复发率，术后腹股沟疼痛已成为这些手术的主要并发症。术后三个月，20%的患者会经历某种程度的疼痛。其中12%的患者疼痛限制了日常活动，1%至3%的患者因神经痛而丧失劳动能力。手术过程中防止感觉神经受损是预防神经痛的一种方法。受损的感觉神经应予以切除。术后神经痛可通过三环类抗抑郁药、阿片类药物或抗癫痫药物缓解。对于选定的神经痛患者，建议进行神经切除术。在其中一名患者中，髂腹股沟神经切除术后神经痛消失。然而，另一名患者的三联神经切除术未成功。
