经腹腹膜前疝修补术治疗阴囊疝术后血清肿的相关危险因素分析及预测模型构建  

Analysis of risk factors and construction of a prediction model for postoperative seroma in laparoscopic transabdominal preperitoneal scrotal hernia repair

作　　者：郝智勇[1] 雷霞[1] 张国锋[1] 李锋[1] Hao Zhiyong;Lei Xia;Zhang Guofeng;Li Feng(Department of General Surgery,People's Hospital of Lvliang City,Lvliang 033000,Shanxi Province,China)

机构地区：[1]吕梁市人民医院普外科,山西033000

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第3期291-295,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：山西省吕梁市科技攻关项目(2019SHFZ47)。

摘　　要：目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)治疗成人阴囊疝术后血清肿发生的危险因素并建立预测模型。方法选择2018年7月至2022年12月就诊于吕梁市人民医院的219例男性阴囊疝病例作为研究对象,分析所选患者的临床资料,采用Logistic回归分析筛选TAPP后血清肿的危险因素。应用R软件完成列线图预测模型。通过受试者工作特征(ROC)曲线评估列线图预测模型的能力。结果所选219例患者中,有57例(26.0%)患者发生了血清肿。单因素分析结果显示,病程大于5年、手术时间大于90 min、疝囊长度大于6.0 cm、疝囊的处理方式、疝囊颈肩部是否有瘢痕是TAPP治疗阴囊疝术后发生血清肿的相关危险因素(P<0.05)。多因素Logistic回归分析结果显示,疝囊处理方式、疝囊长度大于6.0 cm为TAPP后血清肿形成的独立危险因素(P<0.05)。根据多因素回归分析结果构建列线图预测模型,ROC曲线下面积为0.746(95%CI 0.671~0.820)。结论疝囊处理方式、疝囊长度大于6.0 cm为TAPP后血清肿形成的独立危险因素,基于以上两项独立危险因素所建立的列线图有助于预测TAPP术后血清肿的发生风险。Objective To explore the risk factors of postoperative seroma in adult scrotal hernia with laparoscopic transabdominal preperitoneal hernia repair(TAPP)and construct a prediction model.Methods A total of 219 patients who were admitted to People's Hospital of Lvliang City from July 2018 to December 2022 were selected as the research subjects,and analyzed the clinical data of the selected patients.Logistic regression analysis was used to screen the risk factors of seroma after laparoscopic TAPP repair.R software was used to complete the drawing of the nomogram prediction model.The receiver operating characteristic curve(ROC)were used to assess predictive model performance.Results Among the selected 219 patients,57(26.0%)patients developed seroma.Univariate analysis showed that hernia history>5 years,operation time>90 min,hernia sac>6.0 cm,management of hernia sac,hernia sac neck shoulder scar were significantly correlated with seroma after laparoscopic TAPP scrotal hernia repair(P<0.05).Multivariate analysis showed that management of hernia sac and hernia sac>6.0 cm were independent risk factors for seroma after laparoscopic TAPP scrotal hernia repair.According to the multivariate logistic regression analysis results,the nomogram prediction model was constructed.The area under the ROC curve is 0.746(95%CI 0.671-0.820).Conclusion Management of hernia sac and hernia sac>6.0 cm are independent risk factors for seroma in adult scrotal hernia with laparoscopic TAPP repair.Based on the above two independent risk factors,the established nomogram helps predict the risk of seroma in adult scrotal hernia with laparoscopic TAPP repair.

关 键 词：腹腔镜 疝修补术 血清肿 危险因素 列线图模型 

分 类 号：R656.21[医药卫生—外科学]