摘要
目的初步探究腹盆腔脂肪及肌肉水平与造口旁疝的发生发展关系。方法回顾性分析2016年1月至2019年7月,安徽医科大学第一附属医院收治的有术前腹盆腔CT接受Miles手术的43例直肠癌患者资料,术后通过随访诊断为造口旁疝,利用CT后处理软件结合患者术前腹盆腔CT扫描图像测量其脂肪与肌肉的脐周横断面面积及由膈肌至耻骨联合上缘的总体积并进行统计分析。结果43例患者中16例患者发生造口旁疝,总发病率为37.21%;单因素分析中患者较大的年龄(P=0.046)、较高的体质量指数(P=0.036)、皮下脂肪面积(SFA)(P=0.003)、内脏脂肪面积(VFA)(P=0.008)、皮下脂肪体积(SFV)(P=0.011)、内脏脂肪体积(VFV)(P=0.003)以及较低的骨胳肌体积(SMV)(P=0.009)是造口旁疝发生的显著危险因素;在多因素分析中,较低的SMV(P=0.022)是造口旁疝的独立危险因素。结论直肠癌Miles术后患者,术前腹盆腔较低的肌肉含量(由SMV量化)是造口旁疝发生发展的独立危险因素。
Objective To explore the relationship between abdominal and pelvic fat and muscle levels and PH(parastomal hernia).Methods A total of 43 patients with abdominal and pelvic CT undergoing Miles surgery in our hospital from January 2016 to July 2019 were retrospectively included in the analysis,and were diagnosed with PH through postoperative follow-up.Using CT post-processing software combined with the abdominal and pelvic CT scan images of preoperative patients to measure the periumbilical cross-sectional area and volume of the fat and the muscle tissue from the diaphragmatic muscle to the upper margin of the pubic bone,which were then used in statistical analysis.Results 16 of the 43 patients developed parastomal hernias,with a total incidence of 37.21%;In univariate analysis,older age(P=0.046),higher body mass index(BMI)(P=0.036),subcutaneous fat area(SFA)(P=0.003),visceral fat area(VFA)(P=0.008),subcutaneous fat volume(SFV)(P=0.011),visceral fat volume(VFV)(P=0.003)and lower skeletal muscle volume(SMV)(P=0.009)were significant risk factors for PH.In multivariate analysis,lower SMV(P=0.026)was an independent risk factor for PH.Conclusion Preoperative lower abdominal and pelvic muscle content(quantified by SMV)is an independent risk factor for PH in patients with colorectal cancer Miles surgery.
作者
张泽华
杨诗怡
熊茂明
张嘉炜
Zhang Zehua;Yang Shiyi;Xiong Maoming;Zhang Jiawei(Department of General Surgery,The 1st Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2023年第1期9-14,共6页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
造口旁疝
危险因素
体质量指数
体层摄影术
X线计算机
骨骼肌体积
Parastomal hernia
Risk factors
Body mass index
Body layer photography,X-ray computer
Skeletal muscle volume
