摘要
目的探讨腹腔镜骶骨固定术(LSC)后60 d内非计划再入院的危险因素。方法采用巢式病例对照研究方法,选取2013年1月至2020年2月于大连市妇女儿童医疗中心(集团)因盆腔器官脱垂(POP)行LSC的病例,将术后60 d内非计划再入院的7例纳入研究组;通过研究组手术日期,检索同一术者在此时间点最为接近的LSC患者,按1∶6比例匹配未再入院的42例纳入对照组。研究年龄、BMI、是否绝经、既往盆腔手术史、恶性肿瘤化/放疗史、排便困扰史、围术期合并症、合并其他盆腹腔手术、手术时间、术中出血量、术后胃肠道症状、术后住院时间、网片暴露、术后发热等对LSC术后60 d内非计划再入院的影响。结果LSC术后60 d内非计划再入院率为6.7%。单因素分析显示:研究组既往盆腔手术史、恶性肿瘤化/放疗史、合并甲状腺疾病、合并其他盆腹腔手术、手术时间、术中出血量、术后胃肠道症状、网片暴露、术后发热指标均高于对照组;多因素回归分析显示:术中出血量、术后胃肠道症状、网片暴露、术后发热是影响LSC术后60 d内非计划再入院的独立危险因素。结论术中出血量多、术后胃肠道症状、网片暴露、术后发热的患者,其术后近期更易发生盆腔感染、不全肠梗阻、阴道断端愈合不良;应加强围术期管理以降低近期再入院率。
Objective To investigate the risk factors of unplanned readmission within 60 days after laparoscopic sacrocolpopexy(LSC).Methods A nested case-control study was conducted in Dalian Maternal and Child Health Hospital from January 2013 to February 2020.7 patients receiving LSC for POP who were not scheduled to be readmitted within 60 days after surgery were included in the study group,and according to the operation date of the study group,with the ratio of 1∶6,42 LSC patients who were closest to this time point of the same surgeon were included,who were not readmitted.To investigate the influence of age,BMI,menopause,previous pelvic surgery history,malignant tumor chemotherapy/radiotherapy history,defecation disturbance history,perioperative complications,other pelvic and abdominal surgery,operation time,intraoperative blood loss,postoperative gastrointestinal symptoms,postoperative hospital stay,mesh exposure,postoperative fever and other factors on unplanned readmission within 60 days after LSC.Results The rate of unplanned readmission within 60 days after LSC was 6.7%.Univariate analysis showed that such indexes as the previous pelvic surgery history,malignant tumor chemotherapy/radiotherapy history,thyroid disease,other pelvic and abdominal surgery,operation time,intraoperative blood loss volume,postoperative gastrointestinal symptoms,mesh exposure and postoperative fever in the study group were higher than those in the control group.Multivariate regression analysis showed that intraoperative blood loss volume,postoperative gastrointestinal symptoms,mesh exposure and postoperative fever were independent risk factors of unplanned readmission within 60 days after LSC.Conclusion The patients with more intraoperative blood loss,postoperative gastrointestinal symptoms,mesh exposure and postoperative fever,are higher likely to have pelvic infection,incomplete intestinal obstruction and poor healing of vaginal stump in the short term after operation.Perioperative management should be strengthened to reduce the short
作者
王美澄
刘启贵
韩璐
WANG Mei-cheng;LIU Qi-gui;HAN Lu(Department of Gynecology,Dalian Obstetrics and Gynecology Hospital,Affiliated to Dalian Medical University,Dalian 116033,China;不详)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2021年第10期1062-1065,共4页
Chinese Journal of Practical Gynecology and Obstetrics
