Nikkolo C, Kirsimägi Ü, Vaasna T, Murruste M, Suumann J, Seepter H, Lepner U
Surgery Clinic, Tartu University Hospital, Puusepa 8, 51014, Tartu, Estonia.
Hernia. 2017 Apr;21(2):199-205. doi: 10.1007/s10029-016-1569-4. Epub 2016 Dec 26.
The definition of chronic pain after inguinal hernioplasty and the methods of its assessment vary a great deal, which make it complicated to conduct meta-analyses. The primary aim of the present prospective study was to evaluate at which pain severity degree the quality-of-life scores will be reduced.
A prospective study of patients operated for inguinal hernia was conducted. A pain questionnaire and a quality-of-life (QoL) questionnaire were completed.
Altogether, 370 patients were investigated and included in analysis. Of them, 33.8% experienced pain during different activities. Compared to the non-pain response group, significantly lower QoL scores for the Bodily pain domain were reported by patients who gave 1, 2, or 3 positive responses to the pain questionnaire. Patients with no pain as well as patients who gave 1 positive response to the pain questionnaire and whose VAS score was ≤20 had similar QoL scores for all domains. Patients who gave 1 positive response to the pain questionnaire and whose VAS score was >20, and patients who gave two or more positive responses to the pain questionnaire, showed significantly lower QoL scores in most of the domains compared with the non-pain group. When the patients who gave 1 positive response to the pain questionnaire and whose VAS score was ≤20 were excluded from the group of patients with pain, the rate of chronic pain was 19.7%. Considering the above result, the reduction in the rate of chronic pain from 33.8 to 19.7% was statistically significant.
Pain scores 20 mm or less on the VAS (0 to 100 mm) have no impact on the patients' quality of life. Uniform assessment methods of chronic pain should be developed to improve the quality of research.
腹股沟疝修补术后慢性疼痛的定义及其评估方法差异很大，这使得进行荟萃分析变得复杂。本前瞻性研究的主要目的是评估在何种疼痛严重程度下生活质量评分会降低。
对接受腹股沟疝手术的患者进行前瞻性研究。完成了一份疼痛问卷和一份生活质量（QoL）问卷。
共对370例患者进行了调查并纳入分析。其中，33.8%的患者在不同活动中经历疼痛。与无疼痛反应组相比，对疼痛问卷给出1、2或3个肯定回答的患者在身体疼痛领域的QoL评分显著更低。无疼痛的患者以及对疼痛问卷给出1个肯定回答且视觉模拟评分（VAS）≤20的患者在所有领域的QoL评分相似。对疼痛问卷给出1个肯定回答且VAS评分>20的患者，以及对疼痛问卷给出两个或更多肯定回答的患者，与无疼痛组相比，在大多数领域的QoL评分显著更低。当对疼痛问卷给出1个肯定回答且VAS评分≤20的患者被排除在疼痛患者组之外时，慢性疼痛发生率为19.7%。考虑到上述结果，慢性疼痛发生率从33.8%降至19.7%具有统计学意义。
VAS（0至100毫米）评分20毫米或更低的疼痛对患者生活质量没有影响。应制定统一的慢性疼痛评估方法以提高研究质量。
