【摘要】 目的:探讨腹腔镜腹股沟疝无张力修补术(LIHR)后并发症的危险因素。方法:采用回顾性病例对照研究方法,收集2009年2月至2015年4月收治的842例成人腹股沟疝患者的临床资料。术后并发症采用电话与门诊方式进行随访。单因素分析采用χ~2检验,有意义的因素纳入多因素logistic回归分析模型中进行检验。结果:共行经腹腹膜前疝修补术371例,全腹膜外疝修补术439例,腹腔内补片植入术32例;术后随访24～94个月,842例患者成功获得随访,86例术后出现并发症。χ~2检验结果显示,年龄、BMI、疝内容物是否完全回纳、手术时间、是否合并慢性阻塞性肺疾病是LIHR术后并发症的影响因素(χ~2=5.681,5.284,5.833,6.010,5.348,P<0.05)。多因素分析结果显示,BMI≥24 kg/m~2(OR=11.973,95%CI:1.637～66.375,P<0.05)、疝内容物不能完全回纳(OR=18.922,95%CI:3.536～88.544,P<0.05)、慢性阻塞性肺疾病(OR=6.536,95%CI:1.175～35.218,P<0.05)是LIHR术后并发症的独立危险因素。结论:LIHR术后常见并发症包括浆液肿、血清肿、急性尿潴留、慢性疼痛、暂时性皮肤感觉异常等,BMI≥24 kg/m~2、疝内容物不能完全回纳、慢性阻塞性肺疾病是LIHR术后并发症的危险因素。更多还原

【Abstract】 Objective:To explore risk factors for postoperative complications of laparoscopic inguinal hernia repair(LIHR).Methods:Retrospective case control study was conducted.Eight hundred and forty-two patients diagnosed with adult inguinal hernia and met criterions were collected from Feb.2009 to Apr.2015.Survey content was postoperative complications.Univariate analysis used χ~2 test,meaningful indicators were analyzed by logistic regression model.Results:Three hundred and seventy-one patients were treated by transabdominal preperitoneal repair,439 patients were treated by totally extraperitoneal repair,32 patients were treated by intraperitoneal onlay mesh.842 patients were followed up for 24-154 months,complications occurred in 86 patients.Univariate χ~2 test revealed that age,body mass index(BMI),whether the hernia contents completely returned,operation time and chronic obstructive pulmonary disease(COPD) were the factors related to postoperative complications of LIHR(χ~2=5.681,5.284,5.833,6.010,5.348,P<0.05).Multivariate logistic regression analysis revealed that BMI≥24 kg/m~2(OR=11.973,95% CI:1.637-66.375,P<0.05),the hernia contents could not completely return(OR=18.922,95% CI:3.536-88.544,P<0.05),COPD(OR=6.536,95% CI:1.175-35.218,P<0.05) were the independent risk factors of postoperative complications of LIHR.Conclusions:Postoperative complications of LIHR include serous swelling,seroma,acute urinary retention,chronic pain and transient paresthesia of the skin.BMI≥24 kg/m~2,the hernia contents can not completely return and COPD are the risk factors of postoperative complications of LIHR.更多还原