JOURNAL OF CLINICAL SURGERY ›› 2019, Vol. 27 ›› Issue (9): 748-750.doi: 10.3969/j.issn.1005-6483.2019.09.007

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Clinical features and diagnosis of chronic pain after hernia repair

  

  • Online:2019-09-20 Published:2019-09-20

Abstract: Objective:To observe the clinical features of patients with chronic pain after hernia repair,and to improve their clinical diagnosis and treatment analysis.Methods:A retrospective analysis was implemented from January 2014 to June 2019,and 47 patients of more than 3 months after hernia repair(including inguinal hernia and incisional hernia)still complained pain in surgery area and surgery around(including lower limbs,waist,expanded to the neck and other limb areas)in the outpatient clinic.All patients were treated and analyzed with Consultationliaison psychiatry research,in order to observe the clinical characteristics of patients and improve the relevant clinical diagnosis,further analysis and treatment.Results:Of the 47 patients,1 case of femoral head necrosis patient,1 case of pubic metastasis of prostate cancer patient,and 1 case of infectious patient were diagnosed by imaging diagnosis.The rest were diagnosed with "psychogenic pain".Among them,25 patients were diagnosed with “aggressive(control)personality conflict”(including 19 males and 6 females),12 patients were diagnosed with “dependednt personality conflicts”(including 6 males and 6 females),and 4 patients were diagnosed with “lonely personality conflicts”(including 4 males).3 patients(2 males and 1 female)refused to be interview treatment.11 patients were treated with antianxiety and antidepression drugs,and they were again referred to the outpatient clinic with pain relief.30 patients lost contact after one interview treatment.3 patients still had repeated outpatient visits and complained that chronic pain persisted without relief.One patient had received three surgical treatments,and the pain was relieved immediately after each operation,but the pain recurred and aggravated after 3 months of surgery.One patient developed pain after TEP for the right inguinal hernia,and was again treated with TAPP for the left inguinal hernia.The postoperative aggravated pain in the patient caused a medical dispute.Conclusion:Patients with chronic psychogenic pain after hernia repair had different degrees of anxiety and depression,and the somatization were diverse.Correct understanding of the nature of psychogenic pain combined with antianxiety and depression treatment can 〖LM〗contribute to treating and improving the chronic psychogenic pain after hernia repair.

Key words: chronic pain, psychogenic pain, hernia repair, anxiety, depression, somnipathy

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