中国实用外科杂志

中国实用外科杂志

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成人腹股沟疝修补术后静脉血栓栓塞症调查及影响因素分析

李绍杰1，杨子昂2，黄    磊1，孟云潇1，李绍春1，庄秋林2，蔡    昭1，胡星辰1，唐健雄1，楼文晖2   

  1. 1复旦大学附属华东医院普外科，上海 200040；2复旦大学附属中山医院普外科，上海 200032
  • 发布日期:2020-07-23

  • Published:2020-07-23

摘要： 目的    分析成人腹股沟疝修补术后静脉血栓栓塞症（VTE）的发生情况，并探讨其防治方法。方法    回顾性分析2018年1—12月复旦大学附属中山医院和复旦大学附属华东医院收治入院的行手术治疗的1002例腹股沟疝病人的临床资料。随访1年，观察VTE的发生情况并分析其相关因素。结果    病人年龄为（68.7±13.8）岁；男性950例，女性52例；BMI为22.8±3.1。急诊手术60例，平诊手术942例；手术时间为（72.7±31.1）min。开放手术745例，腹腔镜手术257例。术后在院期间发生VTE共6例，出院后2~48 d另有6例确诊VTE，总发生率为1.2%，除1例肺栓塞（PE）病人死亡外，其他病人经过治疗均好转或痊愈。VTE的发生与疝的临床分型、急诊手术具有相关性（P<0.05）。结论    更严重的临床类型和急诊手术可显著增高成人腹股沟疝术后VTE的发生率，应尽早给予治疗，并在术后适当延长随访时间。

关键词: 腹股沟疝, 并发症, 静脉血栓栓塞症, 影响因素

Abstract: Investigation and influencing factors of venous thromboembolism after inguinal hernia repair in adults                 LI Shao-jie*，YANG Zi-ang，HUANG Lei，et al. *Department of General Surgery，Huadong Hosptial Affiliated to Fudan University，Shanghai 200040，China
Corresponding authors：LOU Wen-hui，E-mail：wenhuilou@aliyun.com；TANG Jian-xiong，E-mail:  johnxiong@china.com
Abstract    Objective    To analyze the incidence of venous thromboembolism (VTE) and its related factors after inguinal hernia repair in adults，and to explore the methods of prevention and treatment. Methods    The clinical data of 1002 cases of inguinal hernias repair from January 2018 to December 2018 in Department of General Surgery of Zhongshan Hospital Affiliated to Fudan University and Department of General Surgery of Huadong Hospital Affiliated to Fudan University were analyzed retrospectively. All the cases were followed up for 1 year and the occurrence of VTE was observed and related factors were analyzed. Results    The mean age of all patients was 68.7±13.8 years old，and there were 950 males and 52 females; the mean BMI was 22.8±3.1；there were 60 emergency operations and 942 routine operations; the mean operation time was （72.7±31.1）min. There were 745 cases of open surgery，257 cases of laparoscopic surgery. Six cases in hospital，and 6 cases of discharge were confirmed of VTE，which led to the 1.2% incidence rate. Except one patient died (PE)，all the other patients were improved or recovered after treatment. The occurrence of VTE was related to clinical classification of hernia，emergency surgery and so on （P<0.05）. Conclusion Serious clinical classification and emergency surgery significantly improve the incidence rate of VTE in adult patients after inguinal hernia operation. It is important to promote the early treatment of inguinal hernia and extend the follow-up time after operation.

Key words: inguinal hernia, complication, venous thromboembolism (VTE), influencing factors