【摘要】 目的探讨成人腹股沟嵌顿疝发生肠坏死的危险因素。方法回顾性研究分析2015年6月至2019年6月,亳州市人民医院疝腹壁外科就诊的130例嵌顿性腹股沟疝并行急诊手术患者的病例资料。观察并记录所有患者的嵌顿时间、嵌顿史、嵌顿类型、腹部手术史、口服抗凝剂史以及伴发腹内压增高疾病等情况。对影响患者肠坏死的危险因素进行单因素分析和Logistic回归分析。结果 130例患者中有19例患者发生肠坏死,发生率为14.62%,发生肠坏死患者的症状持续时间、住院时长以及口服抗凝药比例显著大于未发生肠坏死患者(P<0.05),但其他临床症状均无统计学差异(P>0.05)。单因素分析结果显示嵌顿时间、嵌顿史、嵌顿类型、腹部手术史、口服抗凝剂史以及伴发腹内压增高疾病对患者发生肠坏死具有显著影响(P<0.05)。Logistic回归分析结果显示嵌顿时间(OR=37.525,95%CI:24.718～56.967)、嵌顿史(OR=3.323,95%CI:1.758～6.284)、嵌顿类型(OR=4.768,95%CI:3.032～7.499)、腹部手术史(OR=10.176,95%CI:6.420～16.129)、口服抗凝剂史(OR=2.678,95%CI:1.333～5.380)是影响嵌顿性腹股沟疝肠坏死的危险因素。结论嵌顿疝持续时长≥48h、腹部手术史、嵌顿史、嵌顿性股疝、口服抗凝剂史是影响成人腹股沟嵌顿疝肠坏死的危险因素,尽早进行手术有利于改善患者预后。更多还原

【Abstract】 Objective To investigate the risk factors of intestinal necrosis for adult incarcerated inguinal hernia. Methods A retrospective analysis was conducted on 130 cases of incarcerated inguinal hernia in Bozhou People’s Hospital from June 2015 to June 2019. The incarceration time, history of incarceration, type of incarceration, history of abdominal surgery, history of oral anticoagulants, and diseases associated with increased intra-abdominal pressure were observed and recorded. The data of patients with postoperative complications of intestinal necrosis were analyzed by univariate analysis and Logistic regression analysis. Results Intestinal necrosis occurred in 19 of 130 patients, the incidence rate was 14.62%. The duration of symptoms, length of hospital stay and rate of oral anticoagulant in patients with intestinal necrosis were significantly longer or larger than those without intestinal necrosis(P<0.05). However, there were no significant differences in other clinical symptoms(P>0.05). Univariate analysis showed that incarceration time, incarceration history, incarceration type, history of abdominal surgery, history of oral anticoagulant, and increased intra-abdominal pressure had significant effects on intestinal necrosis(P<0.05); Logistic regression analysis showed incarceration time(OR=37.525, 95% CI 24.718～56.967), incarceration history(OR=3.323, 95% CI 1.758～6.284), incarceration type(OR=4.768, 95% CI 3.032～7.499), history of abdominal surgery(OR=10.176, 95% CI 6.420～16.129), and oral anticoagulant history(OR=2.678, 95% CI 1.333～5.380) were risk factors for incarcerated inguinal hernia and intestinal necrosis. Conclusion The duration of incarcerated hernia ≥48 h, the history of abdominal surgery, incarcerated history, incarcerated femoral hernia, and oral anticoagulant are the risk factors for intestinal necrosis. And carrying out the operation as soon as possible will help improve the patient’s prognosis.更多还原