腹腔镜腹股沟疝修补术后血清肿的风险因素分析  

The risk factor analysis of seroma after laparoscopic inguinal hernia repair

作　　者：朱同恩 龚道军[1] 宗科 Zhu Tongen

机构地区：[1]浙江大学医学院附属金华医院,321000

出　　处：《浙江临床医学》2025年第2期190-192,196,共4页Zhejiang Clinical Medical Journal

基　　金：金华市科技计划重点项目(20213066)。

摘　　要：目的通过Logistic回归分析,识别腹腔镜腹股沟疝修补术后血清肿的风险因素。方法选取2021年7月至2023年7月在本院接受腹腔镜腹股沟疝修补术的426例患者作为研究对象。根据术后1个月内是否发生血清肿,将患者分为发生组(51例)和未发生组(375例)。通过回顾性收集临床资料,采用单因素分析和Logistic回归方法,分析血清肿的风险因素,并构建预测模型,采用ROC曲线评估模型的预测价值。结果与未发生组比较,发生组体质量指数(BMI)≥24 kg/m^(2)、双侧疝、补片固定、合并基础疾病、病程≥3年及直疝患者比例较高,且术前血清白蛋白、总蛋白水平更低,差异有统计学意义(P<0.05)。多因素Logistic分析显示,BMI≥24 kg/m^(2)、双侧疝、补片固定、合并基础疾病、病程≥3年、直疝、术前血清白蛋白和总蛋白水平更低(P<0.05)是腹腔镜疝修补术后血清肿的独立危险因素。基于Logistic回归结果构建的预测模型,经Hosmer-Lemeshow拟合优度检验表明模型拟合效果良好(χ^(2)=6.524,DF=5,P=0.612),显示出良好的预测价值。ROC曲线评估显示,模型预测的AUC值为0.869,敏感度为82.35%,特异度为82.67%,表明模型区分度较好。结论腹腔镜腹股沟疝修补术后血清肿的独立危险因素包括BMI≥24 kg/m^(2)、双侧疝、补片固定、合并基础疾病、病程≥3年、直疝以及术前血清白蛋白和总蛋白水平更低,据此构建的预测模型具有较高的预测价值,可为临床预防提供数据支持,改善患者预后。Objective To identify the risk factors for seroma after laparoscopic inguinal hernia repair using logistic regression analysis.Methods A total of 426 patients who underwent laparoscopic inguinal hernia repair at our hospital from July 2021 to July 2023 were included as research subjects.Patients were divided into two groups based on whether they developed seroma within one month after surgery,the seroma group(51 cases)and the nonseroma group(375 cases).Clinical data were retrospectively collected,and univariate analysis and logistic regression methods were used to explore the risk factors for seroma,and a predictive model was constructed.The predictive value of the model was assessed using the receiver operating characteristic(ROC)curve.Results Compared with the non-seroma group,the seroma group had a higher proportion of patients with body mass index(BMI)≥24 kg/m^(2),bilateral hernias,mesh fixation,underlying diseases,disease course≥3 years,and direct hernias,and lower preoperative serum albumin and total protein levels,with statistically significant differences(P<0.05).Multivariate logistic analysis showed that BMI≥24 kg/m^(2),bilateral hernias,mesh fixation,underlying diseases,disease course≥3 years,direct hernias,and lower preoperative serum albumin and total protein levels(P<0.05)were independent risk factors for seroma after laparoscopic hernia repair.The predictive model constructed based on the logistic regression results showed good model fit with the Hosmer-Lemeshow goodness-of-fit test(Chi-Square=6.524,DF=5,P=0.612),indicating good predictive value.The ROC curve assessment showed that the model's area under the curve(AUC)value for predicting seroma was 0.869,with a sensitivity of 82.35%and a specificity of 82.67%,indicating good model discrimination.Conclusion Independent risk factors for seroma after laparoscopic inguinal hernia repair include BMI≥24 kg/m^(2),bilateral hernias,mesh fixation,underlying diseases,disease course≥3 years,direct hernias,and lower preoperative serum albumin and t

关 键 词：腹腔镜腹股沟疝修补术 血清肿 风险因素 白蛋白 总蛋白 

分 类 号：R65[医药卫生—外科学]