分析成人脐疝修补术开放及腹腔镜术式的分布情况，探讨影响术式选择的相关因素。

回顾性分析2008年3月1日至2022年6月30日，首都医科大学附属北京朝阳医院疝和腹壁外科收治的成人脐疝患者的临床资料，调查开放和腹腔镜修补术的术式分布情况。采用单因素分析法分析影响术式选择的相关因素，对筛选出的相关影响因素，进一步采用多因素Logistics回归模型探究影响术式选择的独立因素。

本研究共纳入脐疝患者1199名，男性472例（39.4%），女性727例（60.6%），平均年龄（57.3±17.3）岁。单因素分析结果显示，年龄、职业、住院次数、入院途径、肺部疾病、心脏病、腹水、低蛋白血症、贫血、诊断类型、麻醉方式、合并其他疝手术在术式选择（开放和腹腔镜）方面差异具有统计学意义（P<0.05）。二元Logistics回归分析结果显示，脐疝合并腹水（OR=0.019，95% CI 0.006~0.067，P<0.001）、贫血（OR=0.337，95% CI 0.180~0.632，P=0.001）、肠梗阻（OR=0.218，95% CI 0.103~0.462，P<0.001）或嵌顿（OR=0.190，95% CI 0.081~0.445，P<0.001）是选择腹腔镜脐疝修补术的独立影响因素。

对于多数成人脐疝修补术首选腹腔镜手术，但对于特殊的合并腹水、贫血、肠梗阻或嵌顿的脐疝，开放手术可能是更合适的选择。临床需要根据患者的具体情况，选择最适合患者的手术方式。

To analyze the distribution of open and laparoscopic repair techniques for adult umbilical hernias and explored the factors influencing the choice of surgical approach.

A retrospective analysis was conducted on the clinical data of adult umbilical hernia patients admitted to the Department of Hernia and Abdominal Wall Surgery at Beijing Chaoyang Hospital, Capital Medical University, from March 1, 2008, to June 30, 2022. The distribution of open and laparoscopic repair techniques was investigated. Univariate analysis was used to analyze the factors influencing the choice of surgical approach, and the independent factors were further explored using a multivariable Logistic regression model.

A total of 1199 umbilical hernia patients were included in this study, including 472 males (39.4%) and 727 females (60.6%), with a mean age of (57.3±17.3) years. The results of univariate analysis showed that age, occupation, hospitalization frequency, admission route, pulmonary disease, heart disease, ascites, hypoalbuminemia, anemia, diagnosis type, anesthesia method, and concomitant other hernia surgeries had statistically significant differences in the choice of surgical approach (open or laparoscopic) (P<0.05). Binary Logistic regression analysis revealed that the presence of ascites (OR=0.019, 95% CI: 0.006-0.067, P<0.001), anemia (OR=0.337, 95% CI: 0.180-0.632, P=0.001), intestinal obstruction (OR=0.218, 95% CI: 0.103-0.462, P<0.001), or incarceration (OR=0.190, 95% CI: 0.081-0.445, P<0.001) were independent factors influencing the choice of laparoscopic umbilical hernia repair.

Laparoscopic surgery is the preferred choice for most adult umbilical hernia repairs. However, for special cases with concurrent ascites, anemia, intestinal obstruction, or incarceration, open surgery may be a more suitable option. The choice of surgical approach should be based on the specific circumstances of the patient.