Starling J R, Harms B A, Schroeder M E, Eichman P L
Department of Surgery, University of Wisconsin, Madison 53792.
Surgery. 1987 Oct;102(4):581-6.
During the past 7 years 30 patients were diagnosed as having either ilioinguinal or genitofemoral entrapment neuralgia. A multidisciplinary approach (surgeon, neurologist, and anesthesiologist), as well as local blocks of the ilioinguinal nerve and/or paravertebral blocks of L-1 and L-2 (genitofemoral nerve), were essential to determine accurately which nerve was specifically involved. Fifteen of the 17 patients (88%) diagnosed as having ilioinguinal neuralgia after previous inguinal herniorrhaphy are pain free after resection of the entrapped portion of the nerve. Thirteen patients were diagnosed as having genitofemoral neuralgia after previous inguinal herniorrhaphy, blunt abdominal trauma, or other surgery. Neurectomy of the genitofemoral nerve proximal to the entrapment controlled the persistent pain in 10 of 13 (77%) of these patients. Ilioinguinal or genitofemoral nerve entrapment neuralgias are rare complications of surgery in the inguinal region. When accurately diagnosed, neurectomy of the specific nerve is highly successful in relieving severe pain and paresthesia without significant morbidity.
在过去7年中，30例患者被诊断为患有髂腹股沟神经或生殖股神经卡压性神经痛。多学科方法（外科医生、神经科医生和麻醉科医生）以及髂腹股沟神经局部阻滞和/或L-1和L-2椎旁阻滞（生殖股神经）对于准确确定具体受累神经至关重要。在先前腹股沟疝修补术后被诊断为髂腹股沟神经痛的17例患者中，有15例（88%）在切除神经受压部分后疼痛消失。13例患者在先前腹股沟疝修补术、腹部钝性创伤或其他手术后被诊断为生殖股神经痛。在这些患者中，对受压近端的生殖股神经进行神经切除术，使13例中的10例（77%）的持续性疼痛得到控制。髂腹股沟神经或生殖股神经卡压性神经痛是腹股沟区手术罕见的并发症。当准确诊断后，对特定神经进行神经切除术在缓解严重疼痛和感觉异常方面非常成功，且发病率不高。
