在内修复后持续的术后疼痛的术后风险因素:系统审查和元分析
Harutyun Alaverdyan1, Jooyoung Maeng1, Peter K Park2
1Department of Anesthesiology, Washington University in St Louis School of Medicine, St. Louis, Missouri.
The journal of pain
|April 10, 2024
概括
在修复后持续的术后疼痛 (PPSP) 与年轻的年龄,女性性别和手术前疼痛有关. 腹腔镜手术和纤维素可以降低PPSP的风险,而不是开放技术和刺.
科学领域:
- 疼痛医学 医学 疼痛医学
- 外科手术的结果
- 证据综合 证据综合
背景情况:
- 持续的术后疼痛 (PPSP) 是 inguinal 修复后的一个显著并发症.
- 确定术后风险因素对于患者分层和制定有针对性的干预措施至关重要.
研究的目的:
- 系统地审查和分析与 Hernia修复后PPSP相关的风险因素.
- 为了比较不同手术技术和网状固定方法的PPSP风险.
主要方法:
- 系统的文献搜索产生了303篇论文,其中140篇包含在元分析中.
- 风险因素分析,包括患者人口统计,的特征和手术变量.
- 评估研究质量和报告方法.
主要成果:
- 年龄较小,女性性别,手术前的疼痛,复发性,以及术后的并发症都会增加PPSP的风险.
- laparoscopic 修复和纤维素接网固定与较低的PPSP率有关,与开放技术和刺针/接相比.
- 在PPSP评估和报告中存在显著的变化,超过75%的研究具有偏差的高或中等风险.
结论:
- 几种患者和手术因素在 inguinal hernia 修复后显著影响 PPSP 风险.
- 腹腔镜方法和纤维素可能在减少PPSP方面提供优势.
- 方法上的局限性要求未来进行高质量的研究,以进行可靠的风险预测和个性化疼痛管理策略.
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