评估全身免疫炎症指数（SII）对腹股沟嵌顿疝患者肠道组织活力的预测价值。

回顾性分析2014年1月至2023年4月因腹股沟嵌顿疝于川北医学院附属医院急诊接受手术且疝内容物仅为肠管的140例患者的病例资料。根据术中肠道组织活力分为非缺血坏死组（49例）和缺血坏死组（91例）。采用独立样本t检验、MannWhitney U检验、χ²检验或Fisher确切概率法进行患者肠缺血坏死影响因素的单因素分析，采用Logistic回归进行多因素分析，利用斯皮尔曼相关性分析探究SII与炎症的相关性，受试者工作特征（ROC）曲线分析确定SII的截断值，评估SII预测肠缺血坏死的诊断价值。

缺血组91例患者中，59例发生不可逆肠缺血行肠切除术，占全部患者的42.1%（59/140）。多因素分析结果显示，白细胞计数升高、嵌顿时间超过2 d、SII增加、血清磷升高是腹股沟嵌顿疝患者发生肠缺血坏死的独立危险因素（P<0.05）。白细胞计数与SII呈正相关（r=0.636；P<0.001）。ROC曲线分析显示，SII指数预测肠道组织活力的ROC曲线下面积为0.820，（95.0% CI 0.744~0.895；P<0.001），最佳截断值为1128.1127，特异度79.6%，灵敏度75.8%。

早期SII指数超过1128.1127与腹股沟嵌顿疝患者肠道组织缺血坏死的不良状况高度相关，可用于腹股沟嵌顿疝患者肠道组织活力的预测。

To assess the predictive value of the systemic immunoinflammatory index (SII) for intestinal tissue viability in patients with incarcerated inguinal hernia.

Case data of 140 patients who underwent surgery for incarcerated inguinal hernia in the emergency department of the Affiliated Hospital of Chuanbei Medical College from January 2014 to April 2023 and whose hernia contents were only intestinal tubes were retrospectively analyzed. According to intraoperative intestinal tissue viability, they were divided into non-ischemic necrosis group (49 cases) and ischemic necrosis group (91 cases). Univariate analysis of factors influencing intestinal ischemic necrosis was performed using the independent-samples t-test, Mann-Whitney U test, χ² test, or Fisher's exact probability test. Multivariate analysis was conducted with logistic regression. Spearman correlation analysis was applied to explore the relationship between the systemic immune-inflammation index (SII) and inflammation. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of SII and to evaluate its diagnostic value in predicting intestinal ischemic necrosis.

Of the 91 patients in the ischemia group, irreversible intestinal ischemia for colectomy occurred in 59 patients, accounting for 42.1% (59/140) of all patients. The results of multifactorial analysis showed that elevated leukocyte count, incarceration duration of more than two days, increased SII, and elevated serum phosphorus (P<0.05) were independent risk factors for the development of intestinal ischemic necrosis in patients with incarcerated hernia in the inguinal area. Leukocyte count was positively correlated with SII (P<0.001) with a correlation coefficient of r=0.636. ROC curve analysis showed that the area under the curve of the SII index predicting intestinal tissue viability was 0.820, with a 95.0% credible interval (0.744~0.895, P<0.001, and the optimal cut-off value was 1128.1127, with a specificity of 79.6% and a sensitivity of 75.8%.

An early SII index of more than 1128.1127 is highly correlated with poor intestinal tissue ischemic necrosis in patients with incarcerated inguinal hernias and can be used to predict intestinal tissue viability in patients with incarcerated inguinal hernias.