Analysis of Risk Factors for Ovarian Necrosis with Ovarian Incarcerated Hernia
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摘要:
目的 分析女性婴幼儿卵巢嵌顿性腹股沟斜疝导致卵巢坏死的危险因素。 方法 回顾性研究昆明市儿童医院2018年6月1日至2021年6月1日间，57例女性婴幼儿卵巢嵌顿性腹股沟斜疝（以下简称为卵巢嵌顿疝）并行手术的患儿，分析患儿的年龄、临床资料、实验室检查、术中有无卵巢扭转，并进行单因素及多因素Logistic回归分析。 结果 共纳入57例女性婴幼儿，中位年龄46 d，最小年龄19 d，最大年龄2岁5月。57例患儿均行手术治疗，术中均证实为卵巢嵌顿。单因素分析结果显示白细胞、CRP、卵巢扭转与卵巢坏死有关（P < 0.05），多因素分析提示卵巢扭转是术中卵巢坏死的独立危险因素（OR = 1.390，95% CI：1.056-1.829，P = 0.019）。 结论 卵巢扭转是婴幼儿卵巢嵌顿性腹股沟疝发生卵巢坏死的独立危险因素。 -
关键词:
- 卵巢嵌顿性腹股沟斜疝 /
- 卵巢扭转 /
- 卵巢坏死 /
- 婴幼儿 /
- 危险因素
Abstract:Objective To explore the risk factors of ovarian necrosis caused by ovarian incarcerated indirect inguinal hernia in female infants. Methods This retrospective study enrolled 57 female infants of incarcerated inguinal hernia （referred to as incarcerated hernia of ovary）who underwent surgery at Children’s Hospital of Kunming from June 1, 2018 to June 1, 2021. And the age, clinical characteristics, laboratory tests, whether there was ovarian torsion during operation, were analyzed. The risk factors of ovarian necrosis were identified by univariate and multivariate Logistic analysis. Results 57 female infants were included in this study, with a median age of 46 days, a minimum age of 19 days, and a maximum age of 2 years and 5 months. All 57 children underwent surgical treatment, and all of them were confirmed to have ovarian incarceration. Univariate analysis showed that white blood cells, CRP, and ovarian torsion were associated with ovarian necrosis （P < 0.05）. Multivariate analysis indicated that ovarian torsion was an independent risk factor for intraoperative ovarian necrosis （OR = 1.390, 95% CI1.056-1.829, P = 0.019）. Conclusion Ovarian torsion is an independent risk factor for ovarian necrosis in infants with ovarian incarcerated inguinal hernia. -
Key words:
- Ovarian incarcerated inguinal hernia /
- Ovarian torsion /
- Ovarian necrosis /
- Infants /
- Risk factors
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图 3 腹腔镜复位后卵巢充血水肿无坏死
Figure 3. Ovarian congestion and edema without necrosis after laparoscopic reduction
表 1 女性婴幼儿卵巢嵌顿疝发生卵巢坏死单因素分析[n（%）]
Table 1. Single factor analysis of ovarian necrosis in female infants with incarcerated ovarian hernia [n（%）]
因素 卵巢坏死组（n = 7） 无卵巢坏死组（n = 50） 统计值 P 年龄 <30 d 0（0） 7（14） a 0.579 >30 d 7（100） 43（86） 嵌顿时间 <12 h 2（28.6） 14（28） χ2 = 0.000 1 ≥12 h 5（71.4） 36（72） 行手法复位 1（14.3） 11（22） χ2 = 0.000 1 未手法复位 6（85.7） 39（78） 白细胞 >10×109/L 7（100） 15（30） a 0.001* ≤10×109/L 0（0） 35（70） C-反应蛋白 >10 mg/L 4（57.1） 1（2） χ2 = 16.950 <0.001* ≤10 mg/L 3（42.9） 49（98） 术中有卵巢扭转 3（42.9） 4（8） χ2 = 4.068 0.044* 术中无卵巢扭转 4（57.1） 46（92） *P < 0.05。 
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表 2 卵巢疝卵巢坏死危险因素多因素分析
Table 2. Multivariate analysis of risk factors for ovarian hernia and necrosis
危险因素 β值 标准误差（S.E.） Waldχ2值 P值 OR值 95%CI 白细胞 0.374 0.210 3.173 0.075 1.454 0.963～2.194 术中发现卵巢扭转 0.329 0.140 5.506 0.019* 1.390 1.056～1.829 CRP 0.669 1.664 0.161 0.688 1.952 0.075～50.903 *P < 0.05。
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