摘要
目的 探讨腹腔镜下切口疝修补（laparoscopic incisional hernia repairs,LIHRs）术后复发的相关危险因素,为LIHRs术后复发的防治提供理论参考.方法 自2010年1月至2014年12月,按照连续采样的方法收集住院治疗并行腹腔镜下修补术的切口疝病人的临床资料.根据病人术后切口疝复发情况将病人分为复发、未复发两组.比较组间病人一般情况,术前、术中及术后恢复情况等指标的差异,采用多因素Logistic回归分析LIHRs术后复发的相关危险因素.结果 复发组与未复发组一般情况比较：两组病人年龄、LIHRs术后住院时间、病变部位相比差异无统计学意义（P＞0.05）;复发组病人病变相对较大,LIHRs手术时间相对较长,多发病变、合并糖尿病、肥胖、吸烟史及术后切口感染的情况更为多见,补片固定器使用率相对较高,正中切口、肋缘下切口术后复发更为常见,组间差异均有统计学意义（P均＜0.05）.且多发病变,既往合并糖尿病、肥胖及吸烟史,LIHRs术后发生切口感染,使用补片固定器,正中切口及肋缘下切口术后等可能是LIHRs术后复发的危险因素（比值比OR值均＞1,P值均＜0.05）.结论 多发病变,既往合并糖尿病、肥胖及吸烟史,LIHRs术后发生切口感染,使用补片固定器,正中切口及肋缘下切口术后,LIHRs术后复发的风险相对较高,临床行LIHRs术时可作为参考.
Objective To investigate the related risk factors of postoperative recurrence after laparoscopic incisional hernia repair （LIHRs） and provide a theoretical relerence lor the prevention of recurrence after LIHRs. Methods According to the continuous sampling method, the clinical data of patients diagnosed with incisional hernia and given LIHRs in our department from Jan. 2010 to Dec. 2014 were collected. Patients were divided into 2 groups according to incisional hernia or not. The difference of generally situations, and intraoperative and postoperative recovery indicators were compared between two groups, and multiariable Logistic regression analysis was used to lind the risk lectors of postoperative recurrence after LIHRs. Results There was no significance difference in age, length of hospital stay after LIHRs and diseased region between two groups （P〉0. 05）. In the recurrent group, there was a relative higher rate of bigger size of hernia defect, longer duration of LIHRs, more common conditions of multiple sectors, history of diabetes mellitus, obesity, smoking, and incisional inlection postoperation, more use of Protack auto suture, and higher recurrent rate following median incision and subcostal incision （P〈0. 05）. Female gender, multiple sectors, history of diabetes mellitus, obesity and smoking, incisional infection following LIHRs, use of Protack auto suture, and conditions after median incision and subcostal incision were probably risk factors of postoperative recurrence after LIHRs （OR 〉1 for all and P〈0. 05 for all）. Conclusions There was a higher post- operative recurrent rate after LIHRs in multiple sectors, history of diabetes mellitus, obesity and smoking, and incisional infection postoperation, use of Protack auto suture and conditions after median incision and subcostal incision.
出处
《腹部外科》
2015年第5期346-349,共4页
Journal of Abdominal Surgery
关键词
腹腔镜下切口疝修补
复发
危险因素
Laparoscopic incisional hernia repair
Recurrence
Risk factors
