Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital & Department of Surgery, Ersta Hospital, Stockholm, Sweden.
Department of Surgery, Centrallasarettet, Västerås, Sweden.
Surgery. 2014 Jan;155(1):106-13. doi: 10.1016/j.surg.2013.06.007. Epub 2013 Aug 22.
Improvement of quality of life (QoL) is the ultimate goal for inguinal hernia repair. Data on QoL before surgery are scarce, and it is not known whether postoperative improvement of QoL relates to preoperative symptoms.
Symptoms and self-reported QoL were evaluated and compared with matched control patients from a normal population in 309 male subjects before and 1 year after unilateral open inguinal hernia repair.
Before operation, 91 % of patients noted a bulge, whereas 75% had symptoms, most commonly pain (64%); the other 25% were asymptomatic. Physical QoL scores (physical component score) were decreased in patients compared with matched controls (median [interquartile range] PCS 47 [38-53] vs 54 [48-57] P < .05), whereas mental scores (mental component score) were not affected (P = .401). PCS was less in patients with pain compared with those without pain (44 [35-50] vs 53 [48-56] P = .001). In patients without pain, no difference was found compared with control patients (P = .57). At 1 year after surgery, PCS was increased to 55 (53-57) in patients and was slightly greater than control patients (P < .05). The increase was greater in patients who reported preoperative pain (from 44 [35-50] to 55 [52-57] vs from 53 [48-56] to 56 [54-57], P < .00001). MCS did not change after inguinal herniorrhaphy.
Preoperative affection as well as postoperative improvement in self-reported physical QoL seems to be strongly associated with preoperative inguinal pain. This finding underscores that occurrence of preoperative pain is an important symptom to evaluate before taking the decision to operate for inguinal hernia.
提高生活质量（QoL）是腹股沟疝修补的最终目标。手术前 QoL 数据稀缺，并且不知道术后 QoL 的改善是否与术前症状有关。
在 309 名男性单侧开放式腹股沟疝修补术前和术后 1 年，评估并比较了症状和自我报告的生活质量，并与来自正常人群的匹配对照患者进行了比较。
手术前，91%的患者有肿块，而 75%的患者有症状，最常见的是疼痛（64%）；另外 25%的患者无症状。与匹配对照相比，患者的身体 QoL 评分（身体成分评分）降低（中位数[四分位距]PCS 47[38-53]比 54[48-57]P<.05），而心理评分（心理成分评分）不受影响（P=.401）。与无疼痛的患者相比，有疼痛的患者 PCS 较低（44[35-50]比 53[48-56]P=.001）。在无疼痛的患者中，与对照患者相比无差异（P=.57）。手术后 1 年，患者的 PCS 增加到 55（53-57），略高于对照患者（P<.05）。报告术前疼痛的患者增加幅度更大（从 44[35-50]增加到 55[52-57]，而从 53[48-56]增加到 56[54-57]，P<.00001）。腹股沟疝修补术后 MCS 无变化。
术前身体 QoL 的影响以及术后自我报告的身体 QoL 的改善似乎与术前腹股沟疼痛密切相关。这一发现强调了术前疼痛的发生是决定是否对腹股沟疝进行手术的一个重要症状。
