老年腹股沟疝患者微创修补术后复发的影响因素分析及预防建议

Analysis of factors influencing recurrence of elderly patients with inguinal hernia after minimally invasive repair and prevention suggestions

目的:探讨分析老年腹股沟疝患者微创修补术后复发的因素及预防建议。方法:回顾230例老年腹股沟疝微创修补术后患者资料,总结可能导致术后复发的危险因素,并进行Logistic回归分析。结果:21例患者复发,复发率为9.13%,其中术后1年复发6例,术后2年复发9例,术后3年复发4例,术后5年复发2例;复发组男性、术前合并糖尿病、术前合并心脏病、术前合并高血压、嵌顿疝、急诊手术、复发疝、手术时间>30 min、聚四氟乙烯补片、BMI>24.9 kg/m^(2)、直疝、疝环重度粘连、手术医师经验不足3年等构成比均明显高于未复发组(P<0.05)。Logistic回归分析证实以上因素均为老年腹股沟疝患者微创修补术后复发的独立危险因素(OR=19.279、4.289、5.403、4.577、4.491、5.078、5.613、5.094、4.614、5.063、6.417、5.778、5.546,P<0.05)。结论:男性、BMI、术前合并糖尿病、术前合并高血压、术前合并心脏病、嵌顿疝、急诊手术、直疝、复发疝、疝环重度粘连、手术时间长、聚四氟乙烯补片、医师经验不足3年等均是老年腹股沟疝患者微创修补术后复发的独立危险因素,需加强防控。

Objective:To explore the factors and preventive suggestions for recurrence of elderly patients with inguinal hernia after minimally invasive repair.Methods:The data of 230 elderly patients with inguinal hernia after minimally invasive repair were retrospectively reviewed.The risk factors for recurrence after minimally invasive repair were summarized.The composition ratio of possible factors between relapsed and non-recurrent patients were compared,then Logistic regression analysis was used.Results:There were 21 patients with recurrence,there were 6 cases of recurrence 1 year after operation,9 cases of recurrence 2 years after operation,4 cases of recurrence 3 years after operation,and 2 cases of recurrence 5 years after operation,and the recurrence rate was 9.13%.The proportions of male,preoperative diabetes,preoperative hypertension,preoperative heart disease,incarcerated inguinal hernia,emergency surgery,recurrent hernia,surgery time exceeds 30 minutes,poly tetra fluoro ethylene ptfe patch,BMI more than the 24.9 kg/m^(2) and sputum and sputum ring,physician experience less than 3 years of recurrence group were significantly higher than those in the non-recurrent group(P<0.05),Logistic regression analysis confirmed the independent risk factors for recurrence of inguinal hernia after minimally invasive repair(OR=19.279,4.289,5.403,4.577,4.491,5.078,5.613,5.094,4.614,5.063,6.417,5.778,5.546,P<0.05).Conclusion:The independent risk factors for recurrence of inguinal hernia after minimally invasive repair include male,BMI,preoperative diabetes,preoperative hypertension,preoperative heart disease,incarcerated inguinal hernia,emergency surgery,direct hernia,recurrent hernia,severe adhesion of ankle ring,long operation time,poly tetra fluoro ethylene ptfe patch,physician experience less than 3 years,which need to be strengthened prevention and control.