儿童腹股沟疝梗阻：评估社会人口统计学变量影响的病例对照研究方法

OBSTRUCTED INGUINAL HERNIA IN CHILDREN: CASE-CONTROLLED APPROACH TO EVALUATE THE INFLUENCE OF SOCIO-DEMOGRAPHIC VARIABLES.

作者信息

Lawal T A, Egbuchulem K I, Ajao A E

机构信息

Department of Surgery, University College Hospital, Ibadan, Nigeria.

出版信息

J West Afr Coll Surg. 2014 Apr-Jun;4(2):76-85.

PMID:26587524

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4500770/

Abstract

BACKGROUND

Obstructed inguinal hernia in children is associated with high morbidity in developing countries due to delay in accessing care. Attempts made to reduce waiting time to herniotomy are not backed by a predictive model of disease occurrence and modeling obstructed inguinal hernia implies knowledge of factors associated with this complication.

AIM & OBJECTIVES: To determine the relationship between socio-demographic variables and obstructed inguinal hernia in children.

DESIGN

Case controlled.

SETTING

Paediatric surgery unit of a tertiary hospital.

MATERIALS AND METHODS

The study was prospective - all children presenting with obstructed inguinal hernia at University College Hospital, Ibadan, Nigeria between May 2009 and April 2014 were studied. For each case, two children with non-obstructed inguinal hernia were recruited consecutively as controls. Their demographics, clinical features, management and outcomes were obtained including the socio-demographic attributes of the parents. The data obtained were computed using SPSS; the p-value for significance was set at < 0.05.

RESULTS

A total of 81 consecutive patients (27 with obstructed inguinal hernia and 54 with non-obstructed inguinal hernia) were studied; they were aged between 2 weeks and 13 years with a mean of 25.9 ± 3.8 months. There were no differences between cases and controls based on gender, parents' religion, tribe, social status and side affected (p > 0.05). The mean age at presentation was 13.7 ± 5.6 months in the obstructed inguinal hernia vs. 32.0 ± 4.8 months in the non-obstructed inguinal hernia groups (p = 0.016). The duration of groin swelling before presentation was not significantly different (30.0 ± 7.7 vs. 28.3 ± 6.4 months, p = 0.893). Infants were three times more likely than older children to develop obstruction (OR = 3.33, CI: 1.20, 9.09, p = 0.020).

CONCLUSION

The age at presentation is the significant socio-demographic variable in this study that could predict obstruction in healthy children with inguinal hernia delivered at term.

摘要

背景

在发展中国家，由于获得治疗的延迟，小儿腹股沟疝嵌顿的发病率较高。为减少疝修补术等待时间所做的努力缺乏疾病发生预测模型的支持，而对腹股沟疝嵌顿进行建模意味着要了解与这种并发症相关的因素。

目的

确定社会人口统计学变量与小儿腹股沟疝嵌顿之间的关系。

设计

病例对照研究。

地点

一家三级医院的小儿外科病房。

材料与方法

本研究为前瞻性研究——对2009年5月至2014年4月期间在尼日利亚伊巴丹大学学院医院就诊的所有腹股沟疝嵌顿患儿进行研究。对于每例病例，连续招募两名非嵌顿性腹股沟疝患儿作为对照。获取他们的人口统计学资料、临床特征、治疗方法及结果，包括父母的社会人口学属性。使用SPSS对获得的数据进行计算；设定显著性p值<0.05。

结果

共对81例连续患者（27例腹股沟疝嵌顿患儿和54例非嵌顿性腹股沟疝患儿）进行了研究；他们的年龄在2周至13岁之间，平均年龄为25.9±3.8个月。病例组和对照组在性别、父母宗教信仰、部落、社会地位及患侧方面无差异（p>0.05）。腹股沟疝嵌顿组患儿就诊时的平均年龄为13.7±5.6个月，非嵌顿性腹股沟疝组为32.0±4.8个月（p = 0.016）。就诊前腹股沟肿胀的持续时间无显著差异（30.0±7.7个月对28.3±6.4个月，p = 0.893）。婴儿发生嵌顿的可能性是大龄儿童的三倍（OR = 3.33，CI：1.20，9.09，p = 0.020）。