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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) ›› 2026, Vol. 20 ›› Issue (02) : 155 -161. doi: 10.3877/cma.j.issn.1674-392X.2026.02.006

论著

中大型切口疝患者的生活质量及其影响因素分析
李靖思1, 张荣华2, 刘景磊2, 高焕宇1, 毛学惠2,†(), 石玉龙2,†()   
  1. 1250102　济南，山东第一医科大学（山东省医学科学院）护理学院
    2250021　济南，山东第一医科大学附属省立医院胃肠外科
  • 收稿日期:2026-03-09 出版日期:2026-04-18
  • 通信作者: 毛学惠, 石玉龙
  • 基金资助:
    山东省自然科学基金(ZR2024MH290、ZR2022MH264); 山东第一医科大学（山东省医学科学院）临床科研先导专项(603D25010)

Quality of life in patients with medium-to-large incisional hernia and its influencing factors

Jingsi Li1, Ronghua Zhang2, Jinglei Liu2, Huanyu Gao1, Xuehui Mao2,†(), Yulong Shi2,†()   

  1. 1School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250102, China
    2Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
  • Received:2026-03-09 Published:2026-04-18
  • Corresponding author: Xuehui Mao, Yulong Shi
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李靖思, 张荣华, 刘景磊, 高焕宇, 毛学惠, 石玉龙. 中大型切口疝患者的生活质量及其影响因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2026, 20(02): 155-161.

Jingsi Li, Ronghua Zhang, Jinglei Liu, Huanyu Gao, Xuehui Mao, Yulong Shi. Quality of life in patients with medium-to-large incisional hernia and its influencing factors[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2026, 20(02): 155-161.

目的

探讨中大型切口疝患者的生活质量现状及其影响因素，为改善患者的生活质量提供依据。

方法

采用回顾性调查法，选取2025年1—12月在山东第一医科大学附属省立医院收治的43例切口疝患者作为研究对象，采用一般资料调查表、癌症患者生活质量量表（EORTC QLQ-C30）、广泛性焦虑障碍量表（GAD-7）、患者健康问卷抑郁量表-9（PHQ-9）和心理一致感量表（SOC-9）进行调查。采用秩和检验、Spearman相关分析及多元逐步线性回归分析生活质量综合得分的影响因素。

结果

切口疝患者生活质量综合得分中位数为87.09（75.00，94.23）分。多元逐步线性回归分析显示，文化程度、衰弱和焦虑是切口疝患者生活质量的独立影响因素（P<0.05）。

结论

切口疝患者的生活质量受生理、心理、社会等多种因素影响，医护人员应重视衰弱筛查与心理状态评估，加强健康教育与心理支持，并结合预康复等综合干预，增强生理储备，进一步提高患者生活质量。

关键词: 切口疝，中大型, 生活质量, 影响因素
Objective

To investigate the current status of quality of life (QoL) in patients with medium-to-large incisional hernia and its influencing factors, and to provide evidence for improving patients' QoL.

Methods

A retrospective survey was conducted among 43 patients with incisional hernia admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University from January to December 2025. Data were collected using a general information questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Sense of Coherence Scale (SOC-9). Rank-sum tests, Spearman correlation analysis, and multiple stepwise linear regression were used to identify factors influencing the QoL summary score.

Results

The median QoL summary score was 87.09 (75.00, 94.23) points. Multiple stepwise linear regression analysis showed that education level, frailty, and anxiety were independent influencing factors of QoL in patients with incisional hernia (P<0.05).

Conclusion

QoL in patients with incisional hernia is affected by multiple factors, including physiological, psychological, and social aspects. Healthcare professionals should emphasize frailty screening and psychological assessment, strengthen health education and psychological support, and implement comprehensive interventions such as prehabilitation to enhance physiological reserve and further improve patients' QoL.

Key words: Incisional hernia, medium-to-large, Quality of life, Influencing factor
表1 切口疝患者生活质量及社会心理状态得分（n=43）
项目 条目数 得分[M(Q1,Q3)]
生活质量 躯体功能 5 86.67(73.33,100.00)
  角色功能 2 100.00(66.67,100.00)
  情绪功能 4 83.33(66.67,100.00)
  认知功能 2 83.33(66.67,100.00)
  社会功能 2 83.33(66.67,100.00)
  总体健康状况/生活质量 2 75.00(58.33,83.33)
  疲乏 3 22.22(0.00,33.33)
  恶心呕吐 2 0.00(0.00,0.00)
  疼痛 2 16.67(0.00,33.33)
  气促 1 0.00(0.00,33.33)
  失眠 1 33.33(0.00,33.33)
  食欲减退 1 0.00(0.00,33.33)
  便秘 1 0.00(0.00,33.33)
  腹泻 1 0.00(0.00,33.33)
  经济困难 1 0.00(0.00,33.33)
  生活质量综合得分 27 87.09(75.00,94.23)
社会心理状态 焦虑 7 0.00(0.00,4.00)
  抑郁 9 1.00(0.00,3.00)
  心理一致感 9 58.00(50.00,63.00)
表2 影响切口疝患者生活质量的单因素分析[n=43，分，M（Q1,Q3）]
项目 例(%) 躯体功能 角色功能 情绪功能 认知功能 社会功能 总体健康状况/生活质量 生活质量综合得分
性别                
男性 20(46.5) 90.00(61.67,100.00) 83.33(70.83,100.00) 91.67(77.08,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 79.17(50.00,100.00) 87.73(75.60,94.13)
女性 23(53.5) 86.67(80.00,93.33) 100.00(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 75.00(58.33,83.33) 85.00(73.68,95.13)
Z值   -0.741 -0.771 -1.288 -0.077 -0.129 -0.602 -0.317
P值   0.458 0.441 0.198 0.939 0.897 0.547 0.752
年龄                
<65岁 27(62.8) 86.67(80.00,100.00) 100.00(83.33,100.00) 83.33(75.00,100.00) 100.00(66.67,100.00) 100.00(66.67,100.00) 75.00(66.67,100.00) 90.85(76.41,95.13)
≥65岁 16(37.2) 86.67(56.67,93.33) 83.33(66.67,100.00) 87.50(66.67,100.00) 75.00(66.67,95.83) 83.33(66.67,100.00) 62.50(50.00,83.33) 80.68(69.12,89.79)
Z值   -1.084 -2.196 -0.217 -1.360 -0.666 -1.446 -1.897
P值   0.278 0.028a 0.828 0.174 0.506 0.148 0.058
体重指数                
18.5~<24.0 kg/m2 8(18.6) 83.33(60.00,91.67) 100.00(87.50,100.00) 79.17(68.75,91.67) 66.67(66.67,95.83) 66.67(66.67,79.17) 83.33(60.00,91.67) 100.00(87.50,100.00)
24.0~<28.0 kg/m2 15(34.9) 93.33(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 100.00(66.67,100.00) 93.33(66.67,100.00) 83.33(66.67,100.00)
≥28.0 kg/m2 20(46.5) 86.67(81.67,98.33) 91.67(70.83,100.00) 87.50(75.00,100.00) 91.67(66.67,100.00) 100.00(83.33,100.00) 86.67(81.67,98.33) 91.67(70.83,100.00)
H值   1.435 1.921 1.120 1.575 5.652 3.134 1.219
P值   0.488 0.383 0.571 0.455 0.059 0.209 0.543
婚姻状况                
已婚 36(83.7) 86.67(75.00,100.00) 100.00(70.84,100.00) 83.33(68.75,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 75.00(52.08,83.33) 88.93(74.01,94.97)
未婚/离异/丧偶 7(16.3) 86.67(60.00,93.33) 83.33(66.67,100.00) 83.33(66.67,100.00) 66.67(66.67,100.00) 83.33(50.00,100.00) 66.67(58.33,75.00) 85.00(78.76,88.38)
Z值   -0.434 -0.521 -0.452 -1.314 -0.784 -0.681 -0.674
P值   0.687 0.640 0.664 0.223 0.468 0.508 0.508
文化程度                
小学及以下 13(30.2) 66.67(53.33,86.67) 100.00(58.33,100.00) 75.00(66.67,95.84) 66.67(66.67,100.00) 66.67(66.67,100.00) 58.33(41.67,79.17) 71.84(67.26,92.14)
初中 12(27.9) 90.00(86.67,98.33) 83.33(66.67,100.00) 83.33(75.00,100.00) 83.33(66.67,95.83) 83.33(83.33,100.00) 79.17(60.42,97.92) 84.53(75.94,90.64)
高中或中专 8(18.6) 90.00(80.00,100.00) 100.00(83.33,100.00) 79.17(66.67,89.58) 83.33(66.67,95.83) 83.33(66.67,100.00) 79.17(68.75,95.83) 85.21(76.37,94.17)
大专及以上 10(23.3) 90.00(85.00,100.00) 100.00(83.33,100.00) 91.67(91.67,100.00) 100.00(100.00,100.00) 100.00(95.83,100.00) 79.17(62.50,87.50) 93.93(91.89,95.81)
H值   6.569 2.552 7.507 9.140 6.994 5.768 8.881
P值   0.087 0.466 0.057 0.027a 0.072 0.123 0.031a
家庭人均月收入                
≤3000元 20(46.5) 86.67(55.00,98.33) 83.33(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 75.00(50.00,83.33) 84.57(69.12,93.10)
3001~5000元 16(37.2) 86.67(81.67,98.33) 100.00(87.50,100.00) 87.50(75.00,97.92) 83.33(66.67,100.00) 100.00(83.33,100.00) 75.00(66.67,83.33) 89.62(79.22,96.09)
≥5001元 7(16.3) 86.67(80.00,100.00) 83.33(83.33,100.00) 91.67(75.00,100.00) 100.00(66.67,100.00) 83.33(66.67,100.00) 75.00(50.00,100.00) 88.72(73.68,95.00)
H值   1.836 4.814 1.044 1.504 3.752 0.564 2.850
P值   0.399 0.090 0.593 0.471 0.153 0.754 0.240
医疗付费方式                
自费 4(9.3) 56.67(53.33,80.00) 66.67(56.67,91.67) 91.67(77.08,100.00) 83.33(56.67,100.00) 91.67(58.33,100.00) 66.67(52.08,81.25) 86.30(69.95,94.81)
职工医保 16(37.2) 86.67(86.67,100.00) 100.00(83.33,100.00) 91.67(83.33,100.00) 83.33(83.33,100.00) 100.00(83.33,100.00) 83.33(66.67,83.33) 90.00(80.60,95.00)
居民医保 23(53.5) 86.67(60.00,100.00) 83.33(66.67,100.00) 70.84(66.67,83.33) 66.67(66.67,100.00) 75.00(66.67,95.83) 58.33(43.75,100.00) 75.71(67.30,90.43)
H值   5.815 5.386 9.287 3.971 6.690 2.800 6.603
P值   0.055 0.068 0.010a 0.137 0.035a 0.247 0.037a
吸烟史                
有 16(37.2) 90.00(61.67,100.00) 91.67(70.83,100.00) 87.50(75.00,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 83.33(52.08,100.00) 86.24(75.60,94.13)
无 27(62.8) 86.67(80.00,93.33) 100.00(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 75.00(58.33,83.33) 88.72(73.68,95.00)
Z值   -0.650 -0.274 -0.716 -0.383 -0.572 -0.901 -0.565
P值   0.516 0.784 0.474 0.702 0.567 0.368 0.572
合并症                
0个 22(51.2) 90.00(75.00,100.00) 100.00(83.33,100.00) 91.67(75.00,100.00) 83.33(66.67,100.00) 91.67(66.67,100.00) 75.00(56.25,83.33) 91.47(78.17,95.03)
1个 11(25.6) 86.67(53.33,86.67) 83.33(66.67,100.00) 75.00(66.67,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 75.00(58.33,91.67) 80.60(69.06,89.15)
≥2个 10(23.3) 90.00(71.67,100.00) 100.00(75.83,100.00) 83.33(79.17,100.00) 75.00(66.67,100.00) 91.67(79.17,100.00) 70.84(50.00,87.50) 84.53(68.74,95.19)
H值   3.443 2.184 1.257 0.155 0.927 0.651 2.667
P值   0.179 0.336 0.534 0.925 0.629 0.722 0.264
衰弱                
是 17(39.5) 80.00(53.33,86.67) 83.33(66.67,100.00) 83.33(66.67,91.67) 66.67(66.67,91.67) 83.33(66.67,100.00) 58.33(50.00,79.17) 77.39(69.17,87.27)
否 26(60.5) 93.33(86.67,100.00) 100.00(83.33,100.00) 87.50(75.00,100.00) 100.00(66.67,100.00) 91.67(79.17,100.00) 83.33(66.67,100.00) 91.90(81.37,95.22)
Z值   -2.975 -1.180 -1.125 -1.892 -1.040 -2.446 -2.720
P值   0.003b 0.238 0.261 0.058 0.298 0.014a 0.007b
是否为疝复发                
是 6(14.0) 83.33(73.33,95.00) 91.67(79.16,100.00) 70.83(62.50,87.50) 83.34(66.67,100.00) 75.00(62.50,100.00) 70.83(58.33,81.25) 88.76(72.52,94.20)
否 37(86.0) 86.67(70.00,100.00) 100.00(66.67,100.00) 91.67(75.00,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 75.00(50.00,83.33) 85.38(75.19,94.62)
Z值   -0.551 0.000 -1.783 -0.092 -1.059 -0.212 -0.105
P值   0.596 1.000 0.083 0.932 0.327 0.851 0.932
切口疝病程                
<6个月 28(65.1) 86.67(61.67,100.00) 100.00(66.67,100.00) 83.33(75.00,100.00) 91.67(66.67,100.00) 91.67(66.67,100.00) 66.67(58.33,89.58) 87.73(69.91,94.66)
6~12个月 6(14.0) 93.33(78.33,100.00) 91.67(66.67,100.00) 95.83(87.50,100.00) 91.67(75.00,100.00) 91.67(70.83,100.00) 83.33(81.25,100.00) 94.04(86.25,95.22)
>12个月 9(20.9) 86.67(76.67,93.33) 100.00(83.33,100.00) 66.67(66.67,87.50) 83.33(66.67,83.33) 83.33(66.67,100.00) 75.00(50.00,79.17) 79.32(74.53,88.12)
H值   0.985 0.229 4.670 1.776 0.424 5.443 2.702
P值   0.611 0.892 0.097 0.411 0.809 0.066 0.259
缺损部位                
正中切口 22(51.2) 86.67(78.33,100.00) 100.00(79.17,100.00) 91.67(81.25,100.00) 100.00(66.67,100.00) 100.00(83.33,100.00) 75.00(56.25,87.50) 91.90(81.60,94.90)
侧方切口 21(48.8) 86.67(63.33,96.67) 83.33(66.67,100.00) 75.00(66.67,91.67) 83.33(66.67,100.00) 66.67(66.67,100.00) 75.00(54.17,83.33) 79.32(72.76,91.69)
Z值   -0.382 -0.969 -2.015 -1.596 -2.948 -0.650 -1.579
P值   0.702 0.333 0.044a 0.111 0.003b 0.516 0.114
缺损大小                
中切口疝 21(48.8) 93.33(83.33,100.00) 100.00(83.33,100.00) 83.33(66.67,95.83) 83.33(66.67,100.00) 100.00(66.67,100.00) 75.00(58.33,100.00) 88.38(74.34,94.94)
大切口疝 22(51.2) 86.67(58.33,93.33) 91.67(66.67,100.00) 87.50(75.00,100.00) 83.33(66.67,100.00) 83.33(66.67,100.00) 70.84(50.00,83.33) 85.19(75.27,93.88)
Z值   -1.726 -0.504 -0.841 -0.511 -0.644 -1.264 -0.255
P值   0.084 0.614 0.401 0.610 0.520 0.206 0.799
腹部手术次数                
1次 26(60.5) 90.00(78.33,100.00) 100.00(83.33,100.00) 83.33(66.67,93.75) 100.00(66.67,100.00) 83.33(66.67,100.00) 79.17(50.00,100.00) 88.93(75.29,94.90)
≥2次 17(39.5) 86.67(56.67,90.00) 100.00(66.67,100.00) 83.33(70.84,100.00) 66.67(66.67,91.67) 83.33(83.33,100.00) 75.00(58.33,83.33) 83.68(69.17,92.35)
Z值   -1.702 -0.610 -0.379 -2.075 -0.698 -0.865 -1.031
P值   0.089 0.542 0.705 0.038a 0.485 0.387 0.303
恶性肿瘤病史                
有 33(76.7) 86.67 (73.33,93.33) 100.00 (75.00,100.00) 83.33 (70.84,100.00) 83.33 (66.67,100.00) 100.00 (66.67,100.00) 75.00 (54.17,83.33) 87.09(75.90,94.00)
无 10(23.3) 96.67 (70.00,100.00) 91.67 (62.50,100.00) 79.17 (66.67,91.67) 83.33 (66.67,100.00) 83.33 (50.00,100.00) 83.33(56.25,100.00) 85.85(72.59,96.29)
Z值   -1.182 -0.455 -1.024 -0.181 -1.386 -1.176 -0.172
P值   0.249 0.681 0.327 0.876 0.194 0.249 0.876
续表2
项目 疲乏 恶心呕吐 疼痛 气促 失眠 食欲减退 便秘 腹泻 经济困难
性别                  
男性 11.11(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,16.67) 0.00(0.00,0.00) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,33.33)
女性 33.33(13.89,52.78) 0.00(0.00,0.00) 16.67(4.17,33.33) 16.66(0.00,33.33) 16.66(0.00,33.33) 0.00(0.00,33.33) 33.32(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
Z值 -0.335 0.000 -0.788 -0.211 -1.376 -1.05 -0.744 -0.077 -1.188
P值 0.738 1.000 0.431 0.833 0.169 0.294 0.457 0.938 0.235
年龄                  
<65岁 11.11(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,16.67) 0.00(0.00,0.00) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,33.33)
≥65岁 33.33(13.89,52.78) 0.00(0.00,0.00) 16.67(4.17,33.33) 16.66(0.00,33.33) 16.66(0.00,33.33) 0.00(0.00,33.33) 33.32(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
Z值 -2.289 -0.111 -1.839 -1.806 -0.601 -0.586 -0.938 -1.195 -0.268
P值 0.022a 0.912 0.066 0.071 0.548 0.558 0.348 0.232 0.789
体重指数                  
18.5~<24.0 kg/m2 33.32(13.89,44.44) 0.00(0.00,0.00) 16.67(4.17,50.00) 0.00(0.00,33.33) 16.67(0.00,58.33) 16.66(0.00,33.33) 16.67(0.00,33.33) 0.00(0.00,25.00) 33.33(0.00,91.67)
24.0~<28.0 kg/m2 22.22(0.00,33.33) 0.00(0.00,16.67) 0.00(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
≥28.0 kg/m2 16.67(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,29.16) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,33.33)
H值 2.060 0.954 1.695 0.375 2.549 0.246 0.911 1.483 2.202
P值 0.357 0.621 0.429 0.829 0.280 0.884 0.634 0.476 0.333
婚姻状况                  
已婚 22.22(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
未婚/离异/丧偶 33.33(11.11,44.44) 0.00(0.00,0.00) 16.67(0.00,50.00) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
Z值 -0.820 -0.436 -0.314 -0.020 -0.769 -0.537 -0.130 -0.918 -0.074
P值 0.429 0.784 0.784 0.987 0.488 0.664 0.910 0.488 0.962
文化程度                  
小学及以下 33.33(11.11,55.56) 0.00(0.00,16.67) 16.67(8.34,50.00) 0.00(0.00,33.33) 33.33(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,50.00) 33.33(0.00,83.33)
初中 27.78(13.89,41.67) 0.00(0.00,12.50) 8.34(0.00,33.33) 0.00(0.00,25.00) 0.00(0.00,58.33) 0.00(0.00,33.33) 16.65(0.00,58.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
高中或中专 16.67(0.00,30.56) 0.00(0.00,0.00) 16.67(0.00,29.17) 0.00(0.00,33.33) 33.33(8.33,33.33) 16.67(0.00,33.33) 16.67(0.00,33.33) 0.00(0.00,25.00) 0.00(0.00,33.33)
大专及以上 0.00(0.00,16.67) 0.00(0.00,0.00) 0.00(0.00,16.67) 0.00(0.00,8.33) 0.00(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,8.33) 0.00(0.00,8.33) 0.00(0.00,0.00)
H值 8.571 4.011 7.787 1.233 3.891 5.137 2.837 0.811 7.581
P值 0.036a 0.260 0.051 0.745 0.273 0.162 0.418 0.847 0.056
家庭人均月收入                  
≤3000元 33.32(11.11,41.66) 0.00(0.00,12.50) 16.67(0.00,33.33) 0.00(0.00,25.00) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,58.33)
3001~5000元 16.67(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,16.67) 0.00(0.00,33.33) 0.00(0.00,58.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,25.00) 0.00(0.00,25.00)
≥5001元 11.11(0.00,22.22) 0.00(0.00,0.00) 16.67(0.00,33.33) 33.33(0.00,33.33) 33.33(0.00,33.33) 33.33(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,66.67)
H值 2.256 0.811 2.781 0.673 0.072 4.838 0.901 0.335 3.543
P值 0.324 0.667 0.249 0.714 0.964 0.089 0.637 0.846 0.170
医疗付费方式                  
自费 22.22(0.00,52.78) 0.00(0.00,0.00) 25.00(4.17,45.83) 0.00(0.00,25.00) 0.00(0.00,0.00) 0.00(0.00,25.00) 16.65(0.00,33.33) 0.00(0.00,50.00) 16.67(0.00,83.33)
职工医保 11.11(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,16.67) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,0.00)
居民医保 33.32(11.11,44.44) 0.00(0.00,16.67) 16.67(0.00,45.83) 0.00(0.00,33.33) 33.33(8.33,58.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,25.00) 33.33(8.33,91.67)
H值 3.365 5.142 3.707 0.256 7.244 7.936 0.423 0.022 14.923
P值 0.186 0.076 0.157 0.880 0.027a 0.019a 0.809 0.989 0.001b
吸烟史                  
有 33.33(2.78,41.67) 0.00(0.00,0.00) 16.67(0.00,50.00) 0.00(0.00,25.00) 0.00(0.00,33.33) 0.00(0.00,33.33) 16.67(0.00,33.33) 0.00(0.00,25.00) 33.33(0.00,83.33)
无 22.22(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,16.67) 0.00(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
Z值 -0.984 -0.111 -1.439 -0.623 -0.724 -0.981 -0.867 -0.143 -1.564
P值 0.325 0.912 0.150 0.533 0.469 0.326 0.386 0.886 0.118
合并症                  
0个 16.67(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,66.67)
1个 22.22(11.11,44.44) 0.00(0.00,16.67) 16.67(0.00,16.67) 0.00(0.00,33.33) 33.33(0.00,66.67) 0.00(0.00,33.33) 33.33(0.00,66.67) 0.00(0.00,0.00) 0.00(0.00,33.33)
≥2个 27.78(0.00,55.56) 0.00(0.00,20.84) 0.00(0.00,37.50) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 33.32(0.00,33.33) 33.33(0.00,41.67) 33.33(0.00,33.33)
H值 0.661 3.277 0.076 3.668 3.283 0.908 4.020 6.337 0.796
P值 0.718 0.194 0.963 0.160 0.194 0.635 0.134 0.042a 0.672
衰弱                  
是 33.33(16.67,50.00) 0.00(0.00,0.00) 16.67(0.00,50.00) 33.33(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 33.30(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
否 11.11(0.00,33.31) 0.00(0.00,0.00) 8.34(0.00,16.67) 0.00(0.00,0.00) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
Z值 -3.248 -0.037 -1.594 -2.278 -1.687 -0.145 -1.194 -0.993 -0.529
P值 0.001b 0.971 0.111 0.023a 0.092 0.885 0.232 0.321 0.597
是否为疝复发                  
是 11.11(0.00,30.56) 0.00(0.00,0.00) 8.34(0.00,41.67) 0.00(0.00,8.33) 16.67(0.00,33.33) 16.67(0.00,33.33) 0.00(0.00,33.33) 16.67(0.00,33.33) 0.00(0.00,50.00)
否 22.22(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,16.67) 0.00(0.00,33.33)
Z值 -0.910 -1.240 -0.019 -0.717 -0.400 -0.245 -0.178 -1.067 -0.295
P值 0.381 0.420 0.986 0.572 0.720 0.851 0.878 0.420 0.798
切口疝病程                  
<6个月 11.11(0.00,44.44) 0.00(0.00,0.00) 16.67(0.00,33.33) 0.00(0.00,25.00) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
6~12个月 16.67(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,20.84) 0.00(0.00,0.00) 0.00(0.00,41.67) 0.00(0.00,8.33) 0.00(0.00,8.33) 0.00(0.00,0.00) 0.00(0.00,50.00)
>12个月 22.22(22.22,33.33) 0.00(0.00,8.34) 16.67(0.00,33.33) 33.33(0.00,33.33) 33.33(16.67,33.33) 33.33(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,33.33)
H值 1.111 1.572 0.016 9.101 1.409 1.413 1.950 2.826 0.208
P值 0.574 0.456 0.992 0.011a 0.494 0.493 0.377 0.243 0.901
缺损部位                  
正中切口 16.67(0.00,33.33) 0.00(0.00,0.00) 0.00(0.00,16.67) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
侧方切口 22.22(5.56,44.44) 0.00(0.00,0.00) 16.67(0.00,41.67) 33.33(0.00,33.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,50.00)
Z值 -0.964 -0.143 -2.384 -0.075 -1.531 -1.997 -0.825 -1.064 -1.444
P值 0.335 0.886 0.017a 0.940 0.126 0.046a 0.410 0.288 0.149
缺损大小                  
中切口疝 11.11(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,25.00) 0.00(0.00,33.33) 33.33(0.00,66.67) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,16.67) 0.00(0.00,33.33)
大切口疝 27.78(0.00,44.44) 0.00(0.00,0.00) 16.67(0.00,37.50) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,41.67)
Z值 -0.816 -0.072 -0.734 -0.452 -2.218 -0.198 -0.289 -0.570 -0.082
P值 0.415 0.943 0.463 0.652 0.027a 0.843 0.773 0.568 0.935
腹部手术次数                  
1次 11.11(0.00,33.33) 0.00(0.00,4.17) 0.00(0.00,33.33) 0.00(0.00,8.33) 16.67(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 16.67(0.00,33.33)
≥2次 22.22(11.11,38.89) 0.00(0.00,0.00) 16.67(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,50.00) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,16.67) 0.00(0.00,33.33)
Z值 -0.796 -0.732 -1.054 -1.416 -0.621 -0.275 -0.646 -0.362 -1.114
P值 0.426 0.464 0.292 0.157 0.535 0.783 0.518 0.717 0.265
恶性肿瘤病史                  
有 22.22(0.00,33.33) 0.00(0.00,0.00) 16.67(0.00,16.67) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33)
无 16.67(0.00,47.22) 0.00(0.00,16.67) 25.00(0.00,37.50) 0.00(0.00,8.33) 33.33(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 0.00(0.00,33.33) 33.33(0.00,100.00)
Z值 -0.044 -0.805 -0.854 -0.926 -0.109 -0.134 -1.024 -0.018 -2.208
P值 0.966 0.600 0.435 0.470 0.921 0.921 0.371 0.989 0.048a
表3 切口疝患者焦虑、抑郁、心理一致感与生活质量各领域及总分的相关性（n=43, rs）
项目 躯体功能 角色功能 情绪功能 认知功能 社会功能 疲乏 恶心呕吐 疼痛
焦虑 -0.347a -0.308a -0.726b -0.436b -0.521b 0.530b 0.139 0.381a
抑郁 -0.253 -0.167 -0.593b -0.366a -0.418b 0.394b 0.101 0.301a
心理一致感 0.266 0.152 0.418b 0.278 0.297 -0.292 -0.348a -0.194
项目 气促 失眠 食欲减退 便秘 腹泻 经济困难 总体健康状况/生活质量 生活质量综合得分
焦虑 0.120 0.347a 0.437b 0.171 0.109 0.281 -0.335a -0.526b
抑郁 0.146 0.470b 0.381a 0.035 0.107 0.374a -0.394b -0.471b
心理一致感 -0.099 -0.154 -0.132 0.051 -0.321a -0.171 0.552b 0.297
表4 自变量赋值及哑变量的设置
自变量 赋值方法
年龄 <65岁=0，≥65岁＝1
文化程度 小学及以下=0，初中=1，高中或中专=2，大专及以上=3
衰弱 否=0，是=1
医疗付费方式 以自费为参照设置哑变量，职工医保(0，1，0)，居民医保(0，0，1)
合并症个数 0个=0，1个=1，≥2个=2
切口疝病程 <6个月=0，6~12个月=1，>12个月=2
缺损部位 正中切口=0，侧方切口=1
缺损大小 中切口疝=0，大切口疝=1
腹部手术次数 1次=0，≥2次=1
恶性肿瘤病史 无=0，有=1
焦虑 原值代入
抑郁 原值代入
心理一致感 原值代入
表5 切口疝患者生活质量影响因素的多元逐步线性回归分析（n=43）
项目 B SE β t P
常数项 85.227 2.637 － 31.883 <0.001
文化程度 3.419 1.182 0.341 2.893 0.006
衰弱 -6.672 2.680 -0.286 -2.490 0.017
焦虑 -1.494 0.430 -0.406 -3.476 0.001
[1]
Fink C, Baumann P, Wente MN, et al. Incisional hernia rate 3 years after midline laparotomy[J]. Br J Surg, 2014, 101(2): 51-54.
[2]
Harji D, Thomas C, Antoniou SA, et al. A systematic review of outcome reporting in incisional hernia surgery[J]. BJS Open, 2021, 5(2): zrab006.
[3]
Hill S, Bullock J, Sanders DL. Quality of Life With a Hernia-A Novel Patient Led Study[J]. J Abdom Wall Surg, 2023, 2: 11214.
[4]
Smith OA, Mierzwinski MF, Chitsabesan P, et al. Health-related quality of life in abdominal wall hernia: let’s ask patients what matters to them?[J]. Hernia, 2022, 26: 795-808.
[5]
Sanders DL, Pawlak MM, Simons MP, et al. Midline incisional hernia guidelines: the European Hernia Society[J]. Br J Surg, 2023, 110(12): 1732-1768.
[6]
Sandø A, Rosen MJ, Heniford BT, et al. Long-term patient-reported outcomes and quality of the evidence in ventral hernia mesh repair: a systematic review[J]. Hernia, 2020, 24(4): 695-705.
[7]
Manoharan S, Liu G, Crump RT, et al. Incisional hernia repair surgery improves patient reported outcomes[J]. Am J Surg, 2020, 219(5): 874-878.
[8]
Giesinger JM, Kieffer JM, Fayers PM, et al. Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust[J]. J Clin Epidemiol, 2016, 69: 79-88.
[9]
黄菲, 韩梅芳. 健康相关生活质量评估在慢性乙型肝炎患者中的应用及进展[J]. 临床肝胆病杂志, 2025, 41(1): 133-140.
[10]
Hulzebos EHJ, Helders PJM, FaviéNJ, et al. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery[J]. JAMA, 2006, 296(15): 1851-1857.
[11]
Yan YL, Yao TQ, Gu CH, et al. The effect of perioperative multimodal rehabilitation on the frailty state of older people patients with frailty gastrointestinal surgery: a randomized controlled trial[J]. BMC Geriatr, 2025, 26(1): 116.
[12]
孙红燕, 李娟. 造口旁疝患者生活质量的影响因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(3): 273-276.
[13]
Efficace F, Gaidano G, Petrucci MT, et al. Association of IMWG frailty score with health-related quality of life profile of patients with relapsed refractory multiple myeloma in Italy and the UK: a GIMEMA, multicentre, cross-sectional study[J]. Lancet Healthy Longev, 2022, 3(9): e628-e635.
[14]
Zhang F, Yan Y, Ge C. Frailty as a predictor of adverse outcomes in patients with gastric cancer: A systematic review and metaanalysis of 75, 357 patients[J]. Ageing Res Rev, 2024, 101: 102528.
[15]
李幼生. 从加速康复外科到预康复——理念更新与临床实践模式转变[J]. 中国实用外科杂志, 2024, 44(2): 155-159.
[16]
李乐平, 梁寒, 王振宁, 等. 胃癌手术预康复管理中国专家共识(2024版)[J]. 中国实用外科杂志, 2024, 44(10): 1081-1089.
[17]
Skořepa P, Ford KL, Alsuwaylihi A, et al. The impact of prehabilitation on outcomes in frail and high-risk patients undergoing major abdominal surgery: A systematic review and metaanalysis[J]. Clin Nutr, 2024, 43(3): 629-648.
[18]
马慧, 孟伊雯, 曹佳, 等. 术前预康复在腹壁切口疝患者中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(3): 306-310.
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