296例疝囊高位结扎术后复发的高危因素研究

Risk factors of recurrence in 296 cases of high ligation of hernia sac

目的探讨斜疝患儿行腹腔镜下疝囊高位结扎术后复发的高危因素。方法选取平煤医疗集团总医院2017年1月至2019年1月收治且行腹腔镜下疝囊高位结扎术296例患儿临床资料进行回归性分析,观察并记录其年龄、性别、病程、疝囊部分、术前是否发生嵌顿、是否采用可吸收结扎线、内环口直径等基本资料,记录复发率,并行单因素分析和非线性Logistic多因素回归分析其危险因素。结果296例患儿复发15例,复发率5.07%,术后1年复发5例(33.3%)、术后1个月内复发4例(26.7%)、术后半年复发6例(40.0%);单因素分析结果显示性别、年龄、内环口直径、是否采用可吸收结扎线因素同术后复发率关系明显(P<0.05);多因素Logistic分析结果显示,年龄、内环口直径及采用可吸收结扎线是术后复发的独立高危险因素(P<0.05)。结论年龄、内环口直径及适用可吸收结扎线为斜疝患儿腹腔镜下疝囊高位结扎术后复发的独立危险因素,临床上应针对此高危因素制定干预措施,以降低术后复发率。

【Objective】To investigate the risk factors for recurrence of laparoscopic high ligation of the hernia sac in children with oblique hernia.【Methods】The clinical data of 296 children who underwent laparoscopic high ligation of the hernia sac in our hospital from January 2017 to January 2019 were selected.The clinical data were analyzed retrospectively.The age,the gender,the disease course,the part of the hernia sac,whether the incarceration occurred before surgery,whether the absorbable ligature line and the diameter of the inner ring mouth were used,the recurrence rate were observed and recorded,and the risk factors were analyzed by parallel univariate analysis and nonlinear logistic multivariate regression analysis.【Results】Of the 296 patients,15 had recurrence,the recurrence rate was 5.07%.Five patients(33.3%)relapsed 1 year after surgery,4 patients(26.7%)relapsed within 1 month after surgery,and 6 patients(40.0%)relapsed after half a year.Univariate analysis showed that gender,age,diameter of the inner ring,and whether or not the absorbable ligature was used were positively proportional to the recurrence rate(P<0.05).Multivariate logistic analysis showed that the age,the diameter of the inner ring and the use of absorbable ligature were independent high risk factors for postoperative recurrence(P<0.05).【Conclusion】Age,internal diameter of the annulus and the application of absorbable ligature are independent risk factors for recurrence of laparoscopic high ligation of the hernia sac in children with oblique hernia.Interventions should be developed for this high risk factor to reduce postoperative recurrence rate.