老年腹股沟疝患者行开放式腹股沟疝补片修补术术后切口疼痛及其影响因素分析

Analysis of incision pain after open inguinal hernia patch repair in elderly patients with inguinal hernia and its influencing factors

中文关键词: 老年  腹股沟疝  开放式腹股沟疝补片修补术  切口疼痛  影响因素  预测模型

英文关键词: elderly  inguinal hernia  open inguinal hernia patch repair  incision pain  influencing factor  prediction model

中文摘要:

      目的 探讨老年腹股沟疝患者行开放式腹股沟疝补片修补术术后切口疼痛情况及影响因素.方法 选取2022年1 月—2023 年1 月在南京医科大学附属第一医院行开放式腹股沟疝补片修补术的362 例老年腹股沟疝患者作为研究对象,统计患者术后切口疼痛情况,并采用二元多因素Logistic分析方法分析术后切口疼痛的影响因素.结果 362 例老年患者视觉模拟评分(VAS)评分为(2.02±0.48)分,其中308 例术后轻度切口疼痛,54 例术后中重度切口疼痛;二元多因素Logistic分析显示,年龄≤75 岁(OR =3.565)、BMI＞24 kg/m2(OR =3.021)、术前VAS评分＞3 分(OR =3.016)、慢性疼痛史(OR =15.048)、复发性疝(OR =4.344)、感染(OR =8.574)、术前焦虑(OR =2.745)均为影响术后切口疼痛的独立危险因素(P＜0.05);成功构建了术后切口疼痛风险预测模型,预测模型AUC为 0.861.结论 年龄≤75 岁、BMI＞24 kg/m2、术前VAS评分＞3 分、慢性疼痛史、复发性疝、感染、术前焦虑均可能为老年开放式腹股沟疝补片修补术术后切口疼痛的高危因素,临床可进行早期预防和干预,以改善术后切口疼痛.

英文摘要:

      Objective To explore incision pain after open inguinal hernia patch repair in elderly patients with inguinal hernia and its influencing factors. Methods A total of 362 elderly patients undergoing open inguinal hernia patch repair in First Affiliated Hospital of Nanjing Medical between January 2022 and January 2023 were enrolled as the research subjects. Their postoperative incision pain was statistically analyzed, and the influencing factors of postoperative incision pain were analyzed by binary multivariate logistic analysis. Results The visual analogue scale (VAS) score of 362 elderly patients was (2. 02 ± 0?? 48) points, of which 308 ones had mild postoperative incision pain and 54 ones had moderate to severe postoperative incision pain. Binary multivariate logistic analysis showed that age≤75 years old (OR =3. 565), BMI >24 kg / m2 (OR =3. 021), pre? operative VAS score >3 points (OR =3. 016), history of chronic pain (OR =15. 048), recurrent hernia (OR =4. 344), infec? tion (OR =8. 574), and preoperative anxiety (OR =2. 745) were all independent risk factors affecting postoperative incision pain (P <0. 05). A prediction model of postoperative incision pain risk was successfully constructed, and the AUC of this pre? diction model was 0. 861. Conclusion Age≤75 years, BMI >24 kg / m2 , preoperative VAS score >3 points, history of chro? nic pain, recurrent hernia, infection and preoperative anxiety may all be high?risk factors for postoperative incision pain in eld? erly patients undergoing open inguinal hernia patch repair. Early prevention and intervention should be carried out in clinical practice to relieve postoperative incision pain.