目的

探讨腹腔镜下食管裂孔疝修补术后吞咽困难的独立危险因素。

方法

回顾性分析2016 年1 月1 日至2022 年12 月31 日在华中科技大学同济医学院附属武汉中心医院疝与腹壁外科行腹腔镜下食管裂孔疝修补术的42 例患者的临床资料。分别采用χ² 检验和Logistics 回归分析进行多因素分析，统计分析患者术后发生吞咽困难的危险因素。

结果

42 例患者中，男性25 例，女性17 例；年龄24～78 岁，平均（63.47±4.77）岁。术后15 例患者发生进食后吞咽困难。Logistic回归分析显示，食管裂孔直径、术前食管测压结果、是否存在睡眠障碍及胃底折叠方式是评价腹腔镜下食管裂孔疝修补术后出现吞咽困难的独立危险因素（P＜0.05）。

结论

腹腔镜下食管裂孔疝修补术后患者出现进食后吞咽困难的主要原因考虑与食管裂孔疝直径、术前食管测压水平、睡眠质量及胃底折叠方式等因素密切相关，在临床诊疗过程中可根据患者个体情况进行个体化治疗，以最大程度减轻患者术后进食哽噎及吞咽困难症状，促进患者的快速康复。

Objective

To investigate the independent risk factors of dysphagia after laparoscopic hiatal hernia repair.

Methods

The clinical data of 42 patients who underwent laparoscopic hiatal hernia repair at the Department of Hernia and Abdominal Wall Surgery, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 1, 2016 to December 31, 2022,were retrospectively analyzed. The chi-square test and logistic regression analysis were used for multivariate analysis respectively, and the risk factors of postoperative dysphagia were statistically analyzed.

Results

Among the 42 patients, 25 were male and 17 were female, and the age ranged from 24 to 78 years old, with an average of (63.47±4.77) years old. After operations, 15 patients developed dysphagia after eating. The diameter of the esophageal hiatus, the results of preoperative esophageal manometry, the existence of sleep disturbance and gastric fundus folding were independent risk factors for dysphagia after laparoscopic hiatal hernia repair (P＜0.05).

Conclusion

The main reasons for dysphagia after eating in patients after laparoscopic hiatal hernia repair are closely related to factors such as the diameter of the esophageal hiatus, preoperative esophageal manometry, sleep quality and fundus fold.Individualized treatment is carried out to minimize the symptoms of postoperative choking and dysphagia,and to promote the rapid recovery of patients.