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腹股沟疼痛综合征,又称运动疝:综述。

Groin Pain Syndrome Known as Sports Hernia: A Review.

机构信息

Division of General and Trauma Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.

Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

出版信息

JAMA Surg. 2020 Apr 1;155(4):340-348. doi: 10.1001/jamasurg.2019.5863.

Abstract

IMPORTANCE

Groin pain in active individuals and athletes without clinical evidence of hernia or hip pathologic findings is challenging for health care clinicians and aggravating for those experiencing pain. Frequently called sports hernia or athletic pubalgia, many surgeons continue to refute the diagnosis because there is a lack of consensus and clear comprehension of the basic pathophysiologic features of this groin pain syndrome.

OBSERVATIONS

Understanding the anatomic and pathophysiologic findings of groin pain syndrome is necessary to appropriately treat this problem. In general, the level of evidence of the literature is of relatively low quality. Exercise-based therapy can be an effective first-line therapy in individuals who develop groin pain syndrome. Surgical therapies are typically reserved for those who experience nonoperative management failure. The common features of the varied surgical procedures include the resultant changes in the vectors of pull on the pubic bone or joint, the defects in the inguinal canal, and the inguinal sensory nerve compression or bowstringing.

CONCLUSIONS AND RELEVANCE

The diagnosis of nonhip, nonhernia, chronic groin pain is common. Understanding the diagnosis and treatment options may facilitate recovery and allow return to an active lifestyle and sport.

摘要

重要性

对于有腹股沟疼痛的活动人群和运动员,且无疝或髋关节病理发现的临床证据,这对医疗保健临床医生来说是一个挑战,对那些正在经历疼痛的人来说则更是雪上加霜。由于缺乏共识以及对这种腹股沟疼痛综合征基本病理生理特征的清晰理解,许多外科医生仍然否认这种诊断,这种疼痛经常被称为运动疝或运动性耻骨联合炎。

观察结果

了解腹股沟疼痛综合征的解剖和病理生理学发现对于正确治疗该问题是必要的。一般来说,文献的证据水平质量相对较低。对于出现腹股沟疼痛综合征的患者,基于运动的治疗可能是一种有效的一线治疗方法。手术治疗通常保留给经历非手术治疗失败的患者。各种手术的常见特征包括对耻骨或关节的拉力向量的变化、腹股沟管的缺陷,以及腹股沟感觉神经的压迫或弓弦状改变。

结论和相关性

非髋关节、非疝、慢性腹股沟疼痛的诊断很常见。了解诊断和治疗选择可能有助于恢复并允许恢复积极的生活方式和运动。

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