探讨腹腔镜腹股沟疝修补术（LIHR）后血肿形成的危险因素及预防对策。

本研究为回顾性病例对照研究，纳入2025年1—12月，空军军医大学唐都医院收治的275例接受LIHR的患者的临床资料进行分析。根据术后是否形成血肿分为血肿组（n=32）和无血肿组（n=243）。收集两组患者的临床资料，采用多因素Logistic回归分析，分析LIHR术后血肿形成的危险因素，并针对相关危险因素提出预防对策。

2组患者的年龄、体重指数、疝部位、疝环直径、手术类型、补片类型比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示，年龄≥65岁（OR 4.735，95% CI 1.510~14.845）、体重指数≥24 kg/m²（OR 3.445，95% CI 1.363~8.707）、双侧疝（OR 4.375，95% CI 1.887~10.144）、疝环直径≥4 cm（OR 5.436，95% CI 1.422~20.773）、手术类型为完全腹膜外疝修补术（OR 3.105，95% CI 1.158~8.322）、补片类型为普通补片（OR 4.088，95% CI 1.266~13.198）均是LIHR术后血肿形成的独立危险因素（P<0.05）。

年龄、体重指数、疝部位、疝环直径、手术类型及补片类型与LIHR术后血肿形成密切相关，是其独立危险因素。可通过适当减重训练、严格遵循手术操作规范、超声刀精细分离、优先使用轻量型补片及加压护理等措施，积极降低血肿发生率。

To explore the risk factors for hematoma formation after laparoscopic inguinal hernia repair (LIHR) and its preventive measures.

This study is a retrospective case-control study. The clinical data of 275 patients who received LIHR and were admitted to Tangdu Hospital, Air Force Medical University from January to December 2025, they were divided into the hematoma group (n=32) and the non-hematoma group (n=243) based on whether a hematoma formed after the operation. The clinical data of both groups were collected and a multivariate logistic regression analysis was performed to analyze the risk factors for hematoma formation after LIHR surgery, and corresponding preventive measures were proposed based on the identified risk factors.

There were statistically significant differences in age, body mass index, location of the hernia, diaphragm diameter, surgical type, and mesh type between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age≥65 years (OR 4.735, 95% CI 1.510-14.845), body mass index≥24 kg/m² (OR 3.445, 95% CI 1.363-8.707), bilateral hernia (OR 4.375, 95% CI 1.887-10.144), diaphragm diameter≥4 cm (OR 5.436, 95% CI 1.422-20.773), surgical type (total extraperitoneal hernia repair) (OR 3.105, 95% CI 1.158-8.322), and conventional mesh type (OR 4.088, 95% CI 1.266-13.198) were all independent risk factors for hematoma formation after LIHR (P<0.05).

The hematoma formation following LIHR are closely associated with age, body mass index, hernia location, diaphragm diameter, surgical type, and mesh type. The incidence of hematoma can be actively reduced through measures such as appropriate weight loss training, strict adherence to surgical operating standards, meticulous dissection using ultrasonic scalpel, preferential use of lightweight mesh, and compression care.