体重指数对腹腔镜食管裂孔疝手术效果的影响：倾向性评分匹配分析  

Effect of body mass index on surgical outcomes of laparoscopic surgery for esophageal hiatal hernia:A propensity score matching study

作　　者：王一帆[1] 金健[1] 李蔼建[1] 刘扬[1] WANG Yifan;JIN Jian;LI Aijian;LIU Yang(Department of Thoracic Surgery,The Affiliated Hospital of Chengdu University,Chengdu,610081,P.R.China)

机构地区：[1]成都大学附属医院胸外科

出　　处：《中国胸心血管外科临床杂志》2020年第3期308-311,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省卫健委资助项目(120583)

摘　　要：目的利用倾向性评分匹配平衡两组不同体重指数(BMI)患者的混杂因素,评价不同BMI对腹腔镜手术治疗食管裂孔疝疗效的影响。方法回顾性分析我院2013年7月至2018年6月行腹腔镜下食管裂孔疝修补加胃底折叠手术治疗患者的临床资料,根据BMI大小将其分为A组(BMI≥24 kg/m^2,77例,男41例、女36例,平均年龄42岁)和B组(BMI<24 kg/m^2,63例,其中男38例、女25例,平均年龄67岁),再将两组患者的性别、年龄、食管裂孔疝的类型、症状主观感受评分、反流性食管炎的程度进行倾向性评分匹配,每组成功匹配51例,对比分析两组的手术疗效。结果两组手术方式、术中并发症、术后并发症、术后住院时间差异均无统计学意义(P>0.05),A组手术时间明显长于B组,差异有统计学意义(P=0.023)。两组术后复发率差异无统计学意义(P=0.741)。结论超重食管裂孔疝患者手术时间明显长于非超重患者,但对手术疗效及并发症无影响。Objective To explore the effect of body mass index(BMI)on the outcomes of laparoscopic surgery for esophageal hiatal hernia.Methods We divided the patients who underwent hiatal hernioraphy and fundoplication surgery in our hospital between July 2013 and June 2018 into two groups according to the BMI:a group A,BMI≥24 kg/m^2,77 patients,41 males,36 females,with an average age of 42 years;a group B:BMI<24 kg/m^2,63 patients,38 males,25 females,with an average age of 67 years,and the age,gender,type of hiatal hernia,score of subjective feeling of symptoms,level of reflux esophagitis were analyzed with the propensity score matching method.Fifty one patients were successfully matched in each group,and the curative effect of surgery was compared between the two groups.Results There was no statistical difference in the type of surgery,intraoperative complications,postoperative complications,and hospital stay between the two groups(P>0.05).The operative time of the group A was significantly longer than that of the group B(P=0.023).There was no statistical difference between the two groups in postoperative recurrence(P=0.741).Conclusion The operative time in overweight patients is significantly longer than that in the nonoverweight patients,but it has no effect on the surgical outcomes and complications.

关 键 词：食管裂孔疝 腹腔镜食管裂孔疝修补术 胃底折叠术 体重指数 倾向性评分匹配 

分 类 号：R655.4[医药卫生—外科学]