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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 302 -305. doi: 10.3877/cma.j.issn.1674-392X.2019.04.004

所属专题： 文献；

论著

股疝患者急诊手术的危险因素分析
吴华1,†(), 郭薇1, 简海1   
  1. 1. 516006　广东省，中信惠州医院外科
  • 收稿日期:2018-12-29 出版日期:2019-08-18
  • 通信作者: 吴华

Risk factors for emergency femoral hernia repair

Hua Wu1,†(), Wei Guo1, Hai Jian1   

  1. 1. Department of Surgery, Zhongxin Huizhou Hospital of Guangdong Province, Huizhou 516006, China
  • Received:2018-12-29 Published:2019-08-18
  • Corresponding author: Hua Wu
  • About author:
    Corresponding author: Wu Hua, Email:
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引用本文：

吴华, 郭薇, 简海. 股疝患者急诊手术的危险因素分析[J]. 中华疝和腹壁外科杂志(电子版), 2019, 13(04): 302-305.

Hua Wu, Wei Guo, Hai Jian. Risk factors for emergency femoral hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(04): 302-305.

目的

探讨股疝患者急诊手术的相关危险因素。

方法

回顾性分析2013年1月至2018年1月，中信惠州医院行股疝手术病程超过1个月103例患者的临床资料。根据手术时机分为急诊手术组（53例）和择期手术组（50例）。对2组患者的临床指标进行单因素分析，将单因素分析中具有统计学意义的因素纳入多因素Logistics回归分析，以确定其是否为股疝急诊手术的独立危险因素。

结果

单因素分析结果显示，2组间年龄、病程、肝硬化、高血压和慢性阻塞性肺疾病比较，差异均有统计学意义（P<0.001、0.004、0.002、0.036、0.001）。Logistic多因素回归分析显示，年龄、病程、肝硬化和慢性阻塞性肺疾病是急诊手术的独立危险因素（OR=1.062、1.099、11.408、5.558，P=0.026、0.016、0.034、0.042）。

结论

高龄、病程较长、合并肝硬化和合并慢性阻塞性肺疾病对病程超过1个月的股疝患者的手术时机选择的影响不容忽视。

关键词: 股疝, 急诊手术, 危险因素
Objective

To explore risk factors for emergency femoral hernia repair.

Methods

We retrospectively analysed data for patients who underwent femoral hernia repair with course of disease above 1 month between January 2013 and January 2018 in Zhongxin Huizhou Hospital of Guangdong Province. According on the surgical opportunity, the patients were divided into two groups: elective surgery and emergency surgery. The perioperative clinical parameters of the two groups were analyzed by univariate analysis. Then, statistically significant factors in the univariate analysis were subjected to multivariate logistic regression analysis to determine if it was an independent risk factor for emergency femoral hernia surgery.

Results

Univariate analysis showed that age (P<0.001), the course of disease (P=0.004), liver cirrhosis (P=0.002), hypertension (P=0.036) and chronic obstructive pulmonary disease (COPD) (P=0.001) were associated with emergency femoral hernia repair. Logistic multivariate regression analyses showed age (OR=1.062, P=0.026), the course of disease (OR=1.099, P=0.016), liver cirrhosis (OR=11.408, P=0.034) and COPD (OR=5.558, P=0.042) were the independent risk factors of emergency femoral hernia repair.

Conclusion

The unneglectable risk factors of patients with femoral hernia surgical opportunity were age, long course of disease, liver cirrhosis and the comorbidities COPD.

Key words: Femoral hernia repair, Emergency surgery, Risk factor
表1 103例股疝患者一般资料情况
变量 变量值
年龄(岁, ±s) ? 68.04±11.84
性别[例(%)] 男性 15(14.6)
女性 88(85.4)
体质量指数(kg/m2, ±s) ? 24.79±3.16
股疝部位[例(%)] 左侧 46(44.7)
右侧 57(55.3)
术式[例(%)] 择期手术 50(48.5)
急诊手术 53(51.5)
吸烟史[例(%)] ? 14(13.6)
合并症[例(%)] 肝硬化 14(13.6)
糖尿病 22(21.4)
高血压 26(25.2)
慢性阻塞性肺疾病 18(17.5)
冠心病 26(25.2)
肾结石 3(2.9)
恶性肿瘤 3(2.9)
肾功能不全 12(11.7)
合并其他疝病 10(9.7)
既往疝病手术史 7(6.8)
表2 急诊手术组和择期手术组患者单因素分析比较
变量 择期手术组(50例) 急诊手术组(53例) P值
年龄(岁,±s) ? 63.32±12.05 72.49±9.81 <0.001
性别[例(%)] 男性 7(14.0) 8(15.1) 0.875
女性 43(86.0) 45(84.9)
体质量指数(kg/m2,±s) ? 24.44±2.37 25.13±3.75 0.266
病程(月,±s) ? 9.94±7.01 13.55±5.27 0.004
股疝部位[例(%)] 左侧 22(44.0) 24(45.3) 0.896
右侧 28(56.0) 29(54.7)
临床症状持续时间(月) 3.94±3.50 5.06±2.26 0.056
吸烟史[例(%)] ? 19(38.0) 18(34.0) 0.669
合并症[例(%)] 肝硬化 1(2.0) 13(24.5) 0.002
糖尿病 9(18.0) 13(24.5) 0.419
高血压 8(16.0) 18(34.0) 0.036
慢性阻塞性肺疾病 2(4.0) 16(30.2) 0.001
冠心病 9(18.0) 17(32.1) 0.100
肾结石 0(0.0) 3(5.7) 0.243
恶性肿瘤 1(2.0) 2(3.8) 1.000
肾功能不全 3(6.0) 9(17.0) 0.153
合并其他疝病 4(8.0) 5(11.3) 0.813
既往疝病手术史 3(6.0) 4(7.5) 1.000
表3 多因素Logistic回归分析结果
危险因素 β Wald OR 95% CI P值
年龄 0.060 4.964 1.062 (1.007~1.120) 0.026
病程 0.095 5.767 1.099 (1.018~1.187) 0.016
肝硬化 2.434 4.504 11.408 (1.205~108.025) 0.034
高血压 0.978 2.732 2.660 (0.834~8.487) 0.098
慢性阻塞性肺疾病 1.715 4.12 5.558 (1.061~29.126) 0.042
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