探究肠造口术后造口旁疝的发生率、危险因素，并构建预测模型。

选取2015年7月至2020年12月，在南京鼓楼医院普外科行肠造口术的155例患者，收集患者资料，进行回顾性分析。根据患者术后是否发生造口旁疝分为对照组（未发生造口旁疝）和造口旁疝组（发生造口旁疝）。对患者的性别、年龄、体重指数、原发性高血压、糖尿病、造口部位（回肠或结肠）、手术时机（急诊或择期）、疾病类型（良性或恶性）、造口方式（端式或袢式）、造口位置（腹膜外或腹膜内）、手术时间、出血量、术后住院时间、术后切口感染、随访时间进行单因素分析。采用多因素Logistic回归分析评估肠造口术后发生造口旁疝的独立危险因素，并建立预测模型。

155例肠造口术患者，发生造口旁疝的患者20例，造口旁疝的发生率为12.9%，其中7例行再次手术治疗，13例行保守治疗。单因素分析显示患者的年龄、体重指数、造口部位（回肠或结肠）、疾病类型（良性或恶性）、造口位置（腹膜外或腹膜内）、术后切口感染是肠造口术后造口旁疝发生的影响因素；性别、原发性高血压、糖尿病、慢性阻塞性肺疾病、手术时机（急诊或择期）、造口方式（端式或袢式）、手术时间、出血量、术后住院时间、随访时间不影响造口旁疝的发生。进一步行多因素Logistic回归分析显示，年龄≥70岁（OR 1.079，95% CI 1.006~1.157，P=0.035）、体重指数≥26.3 kg/m²（OR 1.190，95% CI 1.021~1.388，P=0.026）、结肠造口（OR 4.629，95% CI 1.132~18.926，P=0.033）和术后切口感染（OR 3.303，95% CI 1.009~10.821，P=0.048）是肠造口术后发生造口旁疝的独立危险因素。

对于年龄≥70岁、体重指数≥26.3 kg/m²、行结肠造口的患者应注意手术的精细操作，预防术后切口感染，并可以考虑行肠造口术联合预防性补片置入术，以降低造口旁疝发生率。

To explore the incidence, risk factors of parastomal hernia after enterostomy, and to construct a prediction model.

Selected 155 patients who underwent enterostomies at the General Surgery Department of Nanjing Drum Tower Hospital from July 2015 to December 2020, collected patient data, and conducted retrospective analysis. Patients were divided into a control group (no parastomal hernia) and a parastomal hernia group (parastomal hernia) according to the occurrence of postoperative parastomal hernia. Univariate analysis was conducted on patient’s gender, age, body mass index (BMI), hypertension, diabetes, colostomy parts (ileum and colon), timing of surgery (emergency or elective), type of disease (benign or malignant), colostomy method (end or loops), colostomy location (extraperitoneal or intraperitoneal), operation time, blood loss, postoperative hospital stay, postoperative incision infection, and follow-up time. Multivariate logistic regression analysis were used to evaluate the risk factors for parastomal hernia after enterostomy, and a prediction model was established.

A total of 155 patients underwent enterostomy, and the incidence of parastomal hernia was 12.9% (20/155). Among them, 7 patients underwent secondary surgery and 13 underwent conservative treatment. Univariate analysis showed that age, BMI, stoma site (ileum or colon), disease type (benign or malignant), stoma location (extraperitoneal or intraperitoneal), and postoperative wound infection were the influencing factors for the occurrence of postoperative stomal hernia. However, gender, hypertension, diabetes, chronic obstructive pulmonary diseases, timing of surgery (emergency or elective), stoma method (end or loop), operation time, blood loss, postoperative hospital stay, and follow-up time did not affect the occurrence of peristomal hernia. Further multivariate logistic regression analysis showed that age ≥70 years (OR 1.079, 95% CI 1.006~1.157, P=0.035), BMI ≥26.3 kg/m² (OR 1.190, 95% CI 1.021~1.388, P=0.026), colostomy (OR 4.629, 95% CI 1.132~18.926, P=0.033) and postoperative wound infection (OR 3.303, 95% CI 1.009~10.821, P=0.048) were independent risk factors for parastomal hernia after enterostomy.

For patients with an age ≥70 years old, BMI ≥26.3 kg/m², and colostomies attention should be paid to a fine operation to prevent incision infection. Enterostomy combined with prophylactic mesh placement can be considered to reduce the incidence of parastomal hernia.