老年腹股沟疝患者行疝修补术后并发症的多因素Logistic回归分析

目的探讨老年腹股沟疝患者行疝修补术后并发症的危险因素，为预防并发症的发生提供依据。 方法选取2017年1至12月安徽医科大学附属六安医院收治的行疝修补术的老年腹股沟疝患者122例作为研究对象，搜集患者的基本临床资料，并随访术后1年的并发症发生情况，采用单因素分析与多因素Logistic回归分析术后并发症发生的危险因素。 结果随访1年，失访患者9例，随访成功的113例患者中有21例存在相关并发症，总发生率为18.58%：其中手术部位感染6例（切口浅表感染4例，皮下脓胀1例，补片感染1例），术后疼痛4例，尿潴留3例，血清肿3例，股静脉血管损伤2例，术后复发2例，膀胱损伤1例。单因素分析结果显示，并发症发生与年龄、粘连程度、内环口大小、术前合并慢性阻塞性肺疾病、麻醉ASA分级与疝内容物是否完全回纳相关（P<0.05）；多因素Logistic回归分析结果显示：年龄、粘连程度、内环口大小与疝内容物是否完全回纳是术后并发症发生的独立危险因素（P<0.05）。 结论老年患者腹股沟疝进行手术治疗后一年内的并发症发生率不低，其中高龄、疝环重度粘连、内环口较大与疝内容物无法完全回纳的患者术后并发症的风险更高，需要重点关注这类术后并发症高危患者以采取相应预防措施。

Multivariate Logistic regression analysis of complications after herniorrhaphy in elderly patients with inguinal hernia

ObjectiveTo explore the risk factors of complications after hernia repair in elderly patients with inguinal hernia, and to provide evidence for preventing complications. MethodsA total of 122 elderly inguinal hernia patients who underwent hernia repair and were admitted to Lu'an Hospital of Anhui Medical University from January 2017 to December 2017 were selected as the research objects. The basic clinical data of the patients were collected and the postoperative complications were followed up for 1 year. The univariate analysis and multivariate Logistic regression were used to analyze the risk factors of postoperative complications. ResultsAfter 1 year of follow-up, 9 patients were lost to follow-up. Of the 113 patients who were followed up successfully, 21 patients had related complications, with a total incidence of 18.58%. Among them, there were 6 cases of surgical site infections (4 superficial wound infection, 1 subcutaneous swelling, and 1 mesh infection), 4 cases of postoperative pain, 3 cases of urinary retention, 3 cases of seroma, 2 cases of femoral vein vascular injury, 2 cases of postoperative recurrence, and 1 case of bladder injury. Univariate analysis showed that the occurrence of complications was related to age, adhesion degree, size of inner ring, preoperative chronic obstructive pulmonary disease, ASA grade of anesthesia, and whether the contents of the hernia were completely reducible (P<0.05); The results of multivariate Logistic regression analysis showed that age, degree of adhesion, size of inner ring, and whether the contents of the hernia were completely reducible were independent risk factors for postoperative complications (P<0.05). ConclusionThe incidence of complications within one year after surgical treatment of inguinal hernia in elderly patients is not low. Among them, patients with advanced age, severe hernia ring adhesion, large inner ring and irreducible hernia contents have a higher risk of postoperative complications. Therefore, it is necessary to focus on such patients at high risk of postoperative complications to take corresponding preventive measures.