目的: 分析并探讨腹腔镜腹股沟疝修补术后血肿的影响因素,明确其主要危险因素,为临床干预提供依据。方法: 选取汕头市中心医院外科于2020年1月至2023年12月间收治的98例行腹腔镜腹股沟疝修补术患者为研究对象,所有患者均接受腹腔镜腹股沟疝修补术治疗。收集患者的基本信息、疝相关特征、手术及术后信息等,术后进行局部彩超检查,记录血肿的发生情况。采用单因素和多因素Logistic回归分析术后血肿的影响因素。结果: 发生血肿的患者共有11例,占总例数的11.22%。多因素Logistic回归分析显示,年龄≥65岁、体质量指数≥24 kg/m2、直疝、双侧疝、疝囊直径≥4 cm、TEP术式、手术时间≥60分钟、术中出血量≥10 mL、使用普通补片及生物蛋白胶固定均为术后血肿的独立危险因素（P<0.05）。结论: 腹腔镜腹股沟疝修补术后血肿的发生与患者个体特征、手术方式、补片类型及固定方式等多种因素密切相关。合理选择手术方式、优化术中操作及术后管理,有助于减少血肿的发生,提高患者的预后效果。
Abstract
Objective To analyze and explore the influencing factors of hematoma formation after laparoscopic inguinal hernia repair, identify the major risk factors, and provide a basis for clinical intervention. Methods A total of 98 patients who underwent laparoscopic inguinal hernia repair at the Surgery Department of Shantou Central Hospital between January 2020 and December 2023 were enrolled in this study. All patients received laparoscopic inguinal hernia repair surgery. Basic patient information, hernia-related characteristics, surgical and postoperative details were collected. Postoperative local color Doppler ultrasonography was performed to record the occurrence of hematoma. Univariate and multivariate Logistic regression analyses were conducted to investigate the factors influencing postoperative hematoma. Results A total of 11 patients developed hematoma, accounting for 11.22% of the total cases. Multivariate Logistic regression analysis revealed that age ≥65 years, BMI ≥24 kg/m2, direct hernia, bilateral hernia, hernia sac diameter ≥4 cm, total extraperitoneal approach (TEP) procedure, operation duration ≥60 minutes, intraoperative blood loss ≥10 mL, and the use of conventional mesh and biological protein glue fixation were independent risk factors for postoperative hematoma (P<0.05). Conclusion The occurrence of hematoma after laparoscopic inguinal hernia repair is closely related to multiple factors including patient characteristics, surgical technique, mesh type, and fixation method. Rational selection of surgical approach, optimization of intraoperative procedures, and postoperative management can help reduce the incidence of hematoma and improve patient prognosis.
关键词
腹股沟疝 /
腹腔镜疝修补术 /
血肿 /
影响因素 /
危险因素
Key words
inguinal hernia /
laparoscopic hernia repair /
hematoma /
influencing factors /
risk factors
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参考文献
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基金
汕头市科技计划医疗卫生类别项目“褐藻胶寡糖替代大网膜对胃十二指肠穿孔患者穿孔愈合及腹腔感染的影响”（汕府科[2020]5号-15）
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