Lau Hung, Fang Christian, Yuen Wai K, Patil Nivritti G
Department of Surgery, University of Hong Kong Medical Center, Queen May Hospital & Tung Wah Hospital, Sheung Wan, Hong Kong.
Surgery. 2007 Feb;141(2):262-6. doi: 10.1016/j.surg.2006.04.014. Epub 2006 Jul 31.
Inguinal hernia is one of the most common surgical pathologies. Research studies on clinical factors predisposing a person for the development of inguinal hernia, however, remain scarce. The objective of the present study was to evaluate the risk factors for the development of inguinal hernia in adult males, using a case-control design in a hospital-based population.
Between January 2002 and January 2004, a total of 1,418 male patients were recruited at the general surgical or hernia clinic of a University-affiliated teaching hospital. Patients were divided into case and control groups according to the presence of a primary inguinal hernia. Each patient was interviewed by a research assistant using a standardized questionnaire. Clinical data were studied by multivariate, logistic regression analyses to identify independent predictors of inguinal hernia in adult males.
Clinical factors associated with the presence of inguinal hernia included a higher work activity index (P = 0.03), a higher total activity index (P = 0.01), a positive family history of inguinal hernia (P < 0.01, odds ratio = 8.73), and chronic obstructive airway disease (P = 0.04, odds ratio = 2.04). After adjustments for the type of hernia, chronic obstructive airway disease was a risk factor only for direct hernia, whereas total activity index and family history of hernia remained significantly related to both direct and indirect hernias. On logistic regression analyses, positive family history of hernia was the only independent predictor for inguinal hernia.
Family history of hernia was the most important determinant factor for developing inguinal hernia in adult males. A male subject who has a positive family history of hernia is 8 times more likely to develop a primary inguinal hernia.
腹股沟疝是最常见的外科疾病之一。然而,关于导致腹股沟疝发生的临床因素的研究仍然很少。本研究的目的是在以医院为基础的人群中采用病例对照设计,评估成年男性腹股沟疝发生的危险因素。
2002年1月至2004年1月期间,在一所大学附属医院的普通外科或疝门诊共招募了1418例男性患者。根据是否存在原发性腹股沟疝将患者分为病例组和对照组。由一名研究助理使用标准化问卷对每位患者进行访谈。通过多变量逻辑回归分析研究临床数据,以确定成年男性腹股沟疝的独立预测因素。
与腹股沟疝存在相关的临床因素包括较高的工作活动指数(P = 0.03)、较高的总活动指数(P = 0.01)、腹股沟疝家族史阳性(P < 0.01,比值比 = 8.73)和慢性阻塞性气道疾病(P = 0.04,比值比 = 2.04)。在对疝的类型进行调整后,慢性阻塞性气道疾病仅为直疝的危险因素,而总活动指数和疝家族史与直疝和斜疝均仍有显著相关性。逻辑回归分析显示,疝家族史阳性是腹股沟疝的唯一独立预测因素。
疝家族史是成年男性发生腹股沟疝的最重要决定因素。有疝家族史阳性的男性发生原发性腹股沟疝的可能性高8倍。