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巨大腹壁疝修补术后腹腔内高压危险因素的 logistic 回归分析:一项回顾性队列研究。

Logistic regression analysis of risk factors for intra-abdominal hypertension after giant ventral hernia repair: a retrospective cohort study.

机构信息

The Third Clinical Medical School of Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.

Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, No. 5 JingYuan Road, Shijingshan District, Beijing, 100043, China.

出版信息

Hernia. 2023 Apr;27(2):305-309. doi: 10.1007/s10029-022-02667-x. Epub 2022 Sep 28.

Abstract

BACKGROUND

Intra-abdominal hypertension (IAH) is a classical complication after giant ventral hernia surgery and may lead to abdominal compartment syndrome (ACS). Assessment of risk factors and prevention of IAH/ACS are essential for hernia surgeons.

METHODS

We performed a retrospective study including 58 giant ventral hernia patients in our center between Jan 1, 2017, and Mar 1, 2022, we recorded age, gender, chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), hypoproteinemia, body mass index (BMI), the ratio of hernia sac volume to abdominal cavity volume (HSV/ACV), defect width, tension reduction procedure (TRP), positive fluid balance (PFB) and IAH of these patients and analyzed the data using univariate and multivariate logistic regression to screen the risk factors for IAH after surgery.

RESULTS

The multivariate analysis showed that HSV/ACV ≥ 25%, hypoproteinemia, and PFB were independent risk factors for the occurrence of IAH after giant ventral hernia repair (P = 0.025, 0.016, 0.017, respectively). We did not find any correlation between postoperative IAH and the patient's age, gender, COPD, CHD, hypertension, T2DM, BMI, defect width, TRP, and PFB.

CONCLUSION

Identifying risk factors is of great significance for the early identification and prevention of IAH/ACS. We found that HSV/ACV ≥ 25%, hypoproteinemia, and PFB were independent risk factors for IAH after giant ventral hernia repair.

摘要

背景

腹腔内高压(IAH)是巨大腹外疝手术后的一种经典并发症,可能导致腹腔间隔室综合征(ACS)。评估危险因素和预防 IAH/ACS 对疝外科医生至关重要。

方法

我们进行了一项回顾性研究,纳入了 2017 年 1 月 1 日至 2022 年 3 月 1 日期间在我院接受治疗的 58 例巨大腹外疝患者,记录了患者的年龄、性别、慢性阻塞性肺疾病(COPD)、冠心病(CHD)、高血压、2 型糖尿病(T2DM)、低蛋白血症、体质量指数(BMI)、疝囊体积与腹腔体积比(HSV/ACV)、缺损宽度、减压术(TRP)、正液体平衡(PFB)和 IAH,并使用单因素和多因素逻辑回归分析数据,以筛选巨大腹外疝修补术后发生 IAH 的危险因素。

结果

多因素分析显示,HSV/ACV≥25%、低蛋白血症和 PFB 是巨大腹外疝修补术后发生 IAH 的独立危险因素(P=0.025、0.016、0.017)。我们未发现术后 IAH 与患者年龄、性别、COPD、CHD、高血压、T2DM、BMI、缺损宽度、TRP 和 PFB 之间存在相关性。

结论

识别危险因素对于早期识别和预防 IAH/ACS 具有重要意义。我们发现,HSV/ACV≥25%、低蛋白血症和 PFB 是巨大腹外疝修补术后发生 IAH 的独立危险因素。

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