Department for Surgical Sciences, Uppsala University, Uppsala, Sweden.
Ann Surg. 2011 Dec;254(6):1017-21. doi: 10.1097/SLA.0b013e31822ba9b6.
To explore the prevalence of and to identify possible risk factors for chronic pain after surgery for femoral hernia.
Chronic pain has become a very important outcome in quality assessment of inguinal hernia surgery. There are no studies on the risk for chronic pain after femoral hernia surgery.
The Inguinal Pain Questionnaire was sent to 1967 patients who had had a repair for primary unilateral femoral hernia between January 1, 1997 and December 31, 2006. A follow-up period of at least 18 months was chosen. Answers from 1461 patients were matched with data recorded in the Swedish Hernia Register and analyzed.
Some degree of pain during the previous week was reported by 24.2% (354) of patients. Pain interfered with daily activities in 5.5% (81) of patients. Emergency surgery (OR = 0.54; 95% CI = 0.40-0.74) and longer time since surgery (OR = 0.93; 95% CI = 0.89-0.98 for each year added) were associated with lower risk for chronic postoperative pain, whereas a high level of preoperative pain was associated with a higher risk for chronic pain (OR = 1.17; 95% CI = 1.10-1.25). Surgical technique was not found to influence the risk for chronic pain in multivariate logistic regression analysis.
Chronic postoperative pain is as important a complication after femoral hernia surgery as it is after inguinal hernia surgery. In contrast to inguinal hernia surgery, no risk factor related to surgical technique was found. Further investigations into the role of preoperative pain are necessary.
探讨股疝手术后慢性疼痛的发生率及其可能的危险因素。
慢性疼痛已成为评估腹股沟疝手术质量的一个非常重要的结果。目前尚无关于股疝手术后发生慢性疼痛的风险因素的研究。
我们向 1967 名 1997 年 1 月 1 日至 2006 年 12 月 31 日期间接受单侧股疝初次修补术的患者发送了《腹股沟疼痛问卷》。选择至少 18 个月的随访期。将 1461 名患者的回答与瑞典疝登记处记录的数据相匹配并进行分析。
24.2%（354 名）的患者在过去一周内存在某种程度的疼痛。5.5%（81 名）的患者疼痛干扰了日常活动。急诊手术（OR = 0.54；95%CI = 0.40-0.74）和手术时间延长（OR = 0.93；95%CI = 0.89-0.98，每年增加）与慢性术后疼痛的风险降低相关，而术前疼痛程度较高与慢性疼痛的风险增加相关（OR = 1.17；95%CI = 1.10-1.25）。多变量逻辑回归分析未发现手术技术是慢性疼痛的危险因素。
慢性术后疼痛是股疝手术后与腹股沟疝手术后同样重要的并发症。与腹股沟疝手术不同，未发现与手术技术相关的风险因素。需要进一步研究术前疼痛的作用。
