摘要
目的探讨结肠造口旁疝的发病率和危险因素。方法采用回顾性队列研究方法。收集2015年1月至2019年1月新乡市中心医院收治的145例行结肠造口术患者的临床病理资料;男86例,女59例;年龄为(59±11)岁。患者术后每6个月复查1次盆腔、腹腔CT,了解患者结肠造口旁疝发生情况。正态分布的计量资料以x±s表示,组间比较采用独立样本t检验。偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示,组间比较采用χ^(2)检验或Fisher确切概率法。采用Kaplan-Meier法分析结肠造口旁疝年累积发病率。采用对数秩检验分析基于临床变量的累积发病率。单因素和多因素分析采用COX比例风险回归模型。结果(1)结肠造口旁疝发生情况。145例患者术后随访时间为86(60~108)个月,其中46例发生结肠造口旁疝,99例未发生结肠造口旁疝。结肠造口旁疝与非结肠造口旁疝患者性别、年龄、体质量指数(BMI)、慢性肝病比较,差异均有统计学意义(χ^(2)=23.28,t=13.27,χ^(2)=6.17、5.82,P<0.05)。(2)结肠造口旁疝年累积发病率。145例患者1、3、5年结肠造口旁疝累积发病率分别为8.5%、26.4%、42.7%。当随访时间>5年,结肠造口旁疝发病率趋于稳定。女性患者5年结肠造口旁疝发病率高于男性(70.7%比20.3%,χ^(2)=12.37,P<0.05),年龄>60岁患者5年结肠造口旁疝发病率高于年龄≤60岁患者(49.8%比20.0%,χ^(2)=10.52,P<0.05),BMI>28kg/m^(2)患者5年结肠造口旁疝发病率高于BM<28kg/m^(2)患者(55.3%比33.2%,χ^(2)=11.76,P<0.05),慢性肝病患者5年结肠造口旁发病率高于非慢性肝病患者(45.2%比32.4%,χ^(2)=15.32,P<0.05)。(3)影响结肠造口旁疝的危险因素分析。多因素分析结果显示:女性、年龄≥60岁、BMI>28kg/m^(2)、慢性肝病是行结肠造口术患者发生造口旁疝的独立危险因素(风险比=2.70,2.51,1.85,5.88,95%可信区间为1.39~6.74,1.01~4.59,1.02~4.87,1.05~8.24,P<0.05)。结论行结肠造
Objective To explore the incidence and risk factors of parastomal hernia after colostomy.Methods The retrospective cohort study was conducted.The clinicopathological data of 145 patients undergoing colostomy in Xinxiang Central Hospital from January 2015 to January 2019 were collected.There were 86 males and 59 females,aged(59±11)years.Patients received pelvic and abdominal computed tomography once every 6 months after colostomy to detect the occurrence of parastomal hernia.Measurement data with normal distribution were represented as Mean+D,and the independent sample t test was used for comparison between groups.Measurement data with skewed distribution were represented as M(range).Count data were represented as absolute numbers,and chi-square test or Fisher exact probability was used for comparison between groups.Kaplan-Meier method was used to analyze the cumulative annual incidence of parastomal hernia.Logarithmic rank test was used to analyze the cumulative incidence based on clinical variables.COX proportional hazard regression model was used for univariate and multivariate analyses.Results(1)Incidence of parastomal hernia after colostomy.All the 145 patients were followed up for 86(range,60-108)months after colostomy,of which 46 cases had parastomal hernia and 99 cases had no parastomal hernia.There were significant differences in gender,age,body mass index(BMI)and chronic liver disease between patients with and without parastomal hernia after colostomy(χ^(2)=23.28,t=13.27,χ^(2)=6.17,5.82,P<0.05).(2)Annual cumulative incidence of parastomal hernia after colostomy.The 1-,3-,and 5-year cumulative incidence of parastromal hernia after colostomy was 8.5%,26.4% and 42.7%,respectively.When the follow-up time is more than 5 years,the incidence of parastromal hernia tended to be stable.The 5-year incidence of parastomal hernia after colostomy in female patients was higher than that in male patients(70.7%vs 20.3%,χ^(2)=12.37,P<0.05).The 5-year incidence of parastomal hernia after colostomy in patients≥60 year
作者
毕民平
杨小伟
娄萌
胡鹏蕴
史保宾
单义明
阮星
赵宏峰
Bi Minping;Yang Xiaowei;Lou Meng;Hu Pengyun;Shi Baobin;Shan Yiming;Ruan Xing;Zhao Hongfeng(Department of General Surgery,Xinxiang Central Hospital,Xinxiang 453001,China;Duke-National University of Singapore Medical School,Singapore 169857,Singapore)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2024年第9期1195-1199,共5页
Chinese Journal of Digestive Surgery
基金
河南省医学科技攻关联合共建项目(LHGJ20220990)。
关键词
疝
造口旁疝
结肠造口术
发病率
危险因素
Hernia
F Parastomal hernia
Colostomy
Incidence rate
Riskfactor
