摘要
目的:研究影响腹壁切口疝患者围手术期并发症发生的危险因素。方法:回顾性分析2013年1月至2020年12月陕西省人民医院212例腹壁切口疝患者的临床资料，采用单因素和多因素分析的方法分析腹壁切口疝围手术期并发症发生的危险因素。结果:212例患者中，30例患者出现围手术期并发症。单因素logistics回归分析显示，年龄校正查尔森合并指数（aCCI）≥3分（OR=2.267，P=0.037）、复发疝（OR=3.250，P=0.029）、反复腹部手术史（OR=0.370，P=0.014）、术前肺功能异常（OR=0.233，P=0.016）、前腹壁中央区域缺损（OR=0.438，P=0.043）、疝环大小≥10 cm（OR=2.636，P=0.014）、术中出血量≥100 ml（OR=7.366，P=0.007）是腹壁切口疝患者围手术期并发症的影响因素。多因素分析结果显示，术前肺功能异常、前腹壁中央区域缺损、疝环大小≥10 cm、术中出血量≥100 ml是并发症发生的独立危险因素（P<0.05）。结论:术前肺功能异常、前腹壁中央区域缺损、疝环大小≥10 cm、术中出血量≥100 ml是腹壁切口疝围手术期并发症的独立危险因素。提示临床医师需重视腹壁切口疝患者危险因素的管理。
Abstract
Objective:To investigate the risk factors affecting the development of perioperative complications of incisional hernia of the abdominal wall.Methods:A retrospective analysis was conducted on the clinical data of 212 patients with abdominal wall incisional hernia treated at Shaanxi Provincial People's Hospital from January 2013 to December 2020. Univariate and multivariate analyses were used to identify the risk factors for perioperative complications in these patients.Results:Univariate logistic regression analysis indicated that an age-adjusted Charlson Comorbidity Index (aCCI) ≥3 (OR=2.267, P=0.037), recurrent hernia (OR=3.250, P=0.029), history of multiple abdominal surgeries (OR=0.370, P=0.014), preoperative pulmonary function abnormalities (OR=0.233, P=0.016), defects in the central region of the anterior abdominal wall (OR=0.438, P=0.043), hernia defect size ≥10 cm (OR=2.636, P=0.014), and intraoperative blood loss ≥100 ml (OR=7.366, P=0.007) were risk factors for perioperative complications in patients with abdominal wall incisional hernia. Multivariate analysis showed that preoperative pulmonary function abnormalities, defects in the central region of the anterior abdominal wall, hernia defect size ≥10 cm, and intraoperative blood loss ≥100 ml were independent risk factors for the occurrence of complications (P<0.05).Conclusion:Preoperative pulmonary function abnormalities, defects in the central region of the anterior abdominal wall, hernia defect size ≥10 cm, and intraoperative blood loss ≥100 ml are independent risk factors for perioperative complications in patients with abdominal wall incisional hernia. This highlights the need for clinicians to manage these risk factors attentively.
基金项目
陕西省创新能力支撑计划(2019GHJD-14)
陕西省创新能力支撑计划(2021TD-40)
陕西省重点研发计划(2019ZDLSF02-09-01)
万方数据