腹股沟疝无张力修补术后感染影响因素分析

Influencing factors for postoperative infection in inguinal hernia patients undergoing tension-free repair

目的 了解腹股沟疝术后感染的病原菌特点及相关因素,为临床预防和治疗提供依据。方法 收集2013年1月-2017年12月在医院疝外科就诊的1 070例行腹股沟疝无张力修补术患者的临床资料,包括腹股沟疝无张力修补术后感染患者159例(感染组),已行单侧腹股沟疝无张力修补术、因对侧腹股沟疝再次住院手术的腹股沟疝术后未感染患者911例(对照组)。单因素及多因素Logistic回归分析筛查腹股疝术后感染病原学特点及影响因素。结果 159例腹股沟疝术后感染患者,127例患者病原菌培养阳性,共检出病原菌130株,其中革兰阳性菌86株占66.2%,主要以金黄色葡萄球菌为主;32例患者培养阴性,病理切片均显示慢性化脓性炎症;Logistic回归分析显示网塞修补(OR=6.014,95%CI:4.161~8.693)是腹股沟疝术后感染的独立影响因素。结论 感染是腹股沟疝无张力修补术后的严重并发症,使用网塞是术后发生感染的独立影响因素。

OBJECTIVE To understand the distribution of pathogens causing postoperative infection in the patients with inguinal hernia and analyze the related factors so as to provide guidance for clinical prevention and treatment. METHODS The clinical data were collected from 1070inguinal hernia patients who underwent the tension-free repair in hernia surgery department from Jan 2013to Dec 2017;159patients who had infection after the tension-free repair were assigned as the infection group,while 911patients who underwent the unilateral tension-free repair, were re-hospitalized for surgery due to the inguinal hernia of the opposite side but did not have the postoperative infection were set as the control group.The univariate analysis and multivariate logistic regression analysis were performed for the etiological characteristics and influencing factors for the postoperative infection in the patients with inguinal hernia.RESULTS Of the 159inguinal hernia patients who had the postoperative infection,127were positive for culture of pathogens.Totally 130strains of pathogens were isolated,86(66.4%)of which were grampositive bacteria,and Staphylococcus aureus was the predominant species.Totally 32patients were negative for culture of pathogens,the pathological section showed that all of the patients had chronic suppurative inflammation. The logistic regression analysis indicated that the mesh plug repair(OR=6.014,95%CI:4.161-8.693)was the independent influencing factor for the postoperative infection in the patients with inguinal hernia.CONCLUSIONThe infection is a severe postoperative complication in the359 4 inguinal hernia patients undergoing the tension-free repair. The use of mesh plus is the independent influencing factor for the postoperative infection.