腔镜腹股沟疝修补术后并发血清肿的相关因素及防治策略探析

Analysis of the related factors and prevention and treatment of the complications of laparoscopic inguinal hernia repair

目的探析腔镜腹股沟疝修补术后并发血清肿的危险因素及防治策略。方法回顾性分析2015年1月~2020年1月本院及惠州市中心人民医院收治的1676例行腹腔镜腹股沟疝修补术治疗的腹股沟疝患者的临床资料,根据术后有无并发血清肿分为血清肿组(n=56)和无血清肿组(n=1620),比较两组临床资料,并采用Logistic多因素回归分析腹股沟疝修补术后并发血清肿危险因素。结果 Logistic多因素回归分析,结果显示,术前合并症(OR=1.499,95%CI:1.152~5.897,P=0.012)、疝分型(OR=6.599,95%CI:1.876~14.183,P<0.001)、疝囊直径(OR=1.461,95%CI:1.088~5.811,P=0.002)、手术方式(OR=2.152,95%CI:1.166~7.801,P=0.006)及疝囊离断(OR=3.886,95%CI:1.361~11.129,P<0.001)为腔镜腹股沟疝修补术后并发血清肿独立危险因素(P<0.05)。结论术前合并症、疝分型、疝囊直径、手术方式及疝囊离断为腹股沟疝修补术后并发血清肿的独立危险因素,临床可通过个体化治疗及精准解剖防治血清肿发生。

Objective To explore the risk factors and prevention and treatment strategies of Seroma after Laparoscopic inguinal hernia repair.Methods Retrospective analysis was made on the clinical data of 1676 patients with inguinal hernia treated by laparoscopic inguinal hernia repair in our hospital and huizhou central people's hospital from January 2015 to January 2020.The patients were divided into Serum Tumor Group(n=56)and non⁃serum Tumor Group(n=1620)according to the presence or absence of serum tumor after inguinal hernia repair.Results Logistic Regression analysis showed that,preopera⁃tive complications(OR=1.499,95%CI:1.152~5.897,P=0.012).The type of hernia(OR=6.599,95%CI:1.876~14.183,P<0.001),the diameter of hernia SAC(OR=1.461,95%CI:1.088~5.811,P=0.002),the operative method(OR=2.152,95%CI:1.166~7.801,P=0.006)and the rupture of hernia SAC(OR=3.886,95%CI:1.361~11.129,P<0.001)were the independent risk factors for the complication of laparoscopic inguinal hernia repair(P<0.05).Conclusion Hernia type,hernia sac diameter,operation method and hernia sac disconnection are independent risk factors of seroma after inguinal hernia repair,the seroma can be prevented and treated by individualized treatment and precise anatomy.