腹股沟疝修补术后补片感染的危险因素初步分析

Preliminary discuss for risk factor of mesh infection following tension hernia repair

目的探讨腹股沟疝修补术后补片感染的危险因素。方法行腹股沟疝修补术的385例病人,其中,336例采用疝环充填式无张力修补术,49例采用平片无张力疝修补术(Lichtenstein)。采用单因素分析方法,分析病人的年龄、性别、手术时间、补片方法、术前合并症及营养状况与术后感染的关系,对有统计学意义的因素行Logistic回归模型多因素分析。结果术后发生补片感染12例(3.1%),单因素分析结果显示,术前合并2型糖尿病、营养不良、手术时间、补片类型与术后补片感染有关(P<0.05),多因素分析结果显示,术前合并2型糖尿病、营养不良、手术时间超过1小时、术中使用聚四氟乙烯补片是无张力疝修补术后补片感染的独立危险因素(P<0.05)。结论 2型糖尿病、营养不良、手术时间超过1小时、术中使用聚四氟乙烯补片是腹股沟疝无张力修补术后补片感染的独立危险因素。

Objective Discuss risk factors of mesh infection following inguinal hernia repair. Methods. Retrospective analysis for the clinical data of 385 patients with inguinal hernia who were in- guinal hernia repair. To analyze the relationship between age, sex, operation time, preoperation complica- tion ,nutritional status and postoperative infection. Statistically significant factors were analyzed by muhiva- riate analysis of Logistic regression models. Results There were 12 cases of mesh infection after operation （ 3.1% ）, The results of single factor analysis showed that ： preoperative type 2 diabetes ,innutrition, opera- tion time,patch type was related to postoperative patch infection（ X2 = 7.33,6. 987,6. 448,16. 505, P 〈 0.05 ）, The results of multivariate analysis showed that：Preoperative type 2 diabetes ,innutrition ,operation time was more than 1 hours,use teflon patch is Independent risk factor of mesh infection after Tension-free repair of inguinal hernia （ OR = 3. 353,4. 996,8. 568,32. 500,95% CI： 1. 029 - 10. 922, 1. 147 21. 750,2. 290 ~ 32. 064,6. 825 ~ 154. 768 ,P 〈0.05 ） ,postoperative follow-up time was 12 ~ 36 months, an average of 24 months. No infection occurred during the follow-up period. Conclusion Type 2 diabe- tes,Innutrition,operation time was more than 1 hours,use Teflon mesh is independent risk factor of mesh infection after Tension-free repair of inguinal hernia.