| 吴浩,张方捷,高国栋.腹壁切口疝术后外科并发症的危险因素分析[J].浙江中西医结合杂志,2020,30(10): |
| 腹壁切口疝术后外科并发症的危险因素分析 |
| Risk factors of surgical complications after abdominal incisional hernia surgery |
| 投稿时间：2020-03-13 修订日期：2020-08-21 |
| DOI： |
| 中文关键词: 腹壁切口疝 外科并发症 危险因素 |
| 英文关键词:abdominal wall incisional hernia Surgical complication Risk factor |
| 基金项目:浙江省基础公益研究计划（LGF20H030007） |
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| 中文摘要: |
| 目的：明确腹壁切口疝修补术后外科并发症的危险因素。方法：回顾性分析了我中心2016年1月至2019年1月收治的86例腹壁切口疝手术患者的临床资料，术后随访一年，记录术后外科并发症的发生情况，并采用logistic回归分析术后外科并发症发生的危险因素。结果：术后外科并发症发生14例，发生率16.279%（14/86）。其中切口愈合不良/感染和疝复发是最常见的并发症。共有6例（6.977%）进行了二次手术，分别是2例补片感染、1例肠瘘和3例疝复发，术后随访一年未有死亡病例发生。单因素分析：手术时间（≥180min）、疝缺损大小（≥8cm）、手术方式（IPOM）具有统计学意义（P<0.05）。 logistic多因素分析：疝缺损大小（OR=4.020，P=0.038,95%CI：1.081-14.952）、手术方式（OR=6.096，P=0.012,95%CI：1.492-24.900）是外科并发症发生的独立危险因素。结论：对于腹壁切口疝患者，在疝缺损较大时（≥8cm）我们需警惕外科并发症的发生。在选择手术方式时，我们更建议采用Sublay手术方式。 |
| 英文摘要: |
| Objective: To determine the risk factors of surgical complications after abdominal incisional hernia repair.Methods: The clinical data of 86 patients with abdominal wall incisional hernia surgery admitted to our center from January 2016 to January 2019 were retrospectively analyzed.?The postoperative follow-up was conducted for one year to record the occurrence of postoperative surgical complications, and the risk factors of postoperative surgical complications were analyzed by logistic regression.Results: There were 14 cases of postoperative surgical complications, with an incidence of 16.279% (14/86).Poor incision healing/infection and hernia recurrence are the most common complications. A total of 6 patients (6.977%) underwent secondary surgery, including 2 cases of patch infection, 1 case of intestinal fistula and 3 cases of hernia recurrence. No deaths occurred during the postoperative follow-up for one year.Univariate analysis: the operation time (≥180min), hernia defect size (≥8cm) and IPOM were statistically significant (P<0.05).Logistic multivariate analysis: the size of hernia defect (OR=4.020，P=0.038,95%CI：1.081-14.952） and surgical method (OR=6.096，P=0.012, 95%CI：1.492-24.900) were independent risk factors for surgical complications.Conclusion: For patients with incisional hernia of abdominal wall, we should be alert to the occurrence of surgical complications when the hernia defect is large (≥8cm).In the choice of surgical methods, we recommend the use of Sublay surgical method. |
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