赵航宇 王耀辉

【摘要】 目的：分析術前中性粒细胞/淋巴细胞比值（NLR）与腹腔镜腹膜前疝修补术（TAPP）术后血清肿的相关性。方法：选取2019年6月-2020年6月于本院确诊并进行TAPP治疗的250例腹股沟疝患者，根据术后是否发生血清肿分为血清肿组与非血清肿组。采用logistic回归分析影响TAPP术后血清肿的影响因素。检测所有患者术前血清指标（TP、ALB、NLR水平），并采用绘制受试者工作特征曲线（ROC）和曲线下面积（AUC）评估术前各血清学指标对TAPP术后血清肿的预测价值。结果：250例患者中25例术后出现血清肿，发生率为10.00%。血清肿组TP、ALB水平均低于非血清肿组，NLR高于非血清肿组（P<0.05）;两组疝囊直径、病程、术中出血量、NLR比较，差异均有统计学意义（P<0.05）;经多因素logistic回归分析结果显示，疝囊直径、术中出血量、NLR均为TAPP术后发生血清肿的影响因素（P<0.05）。ROC曲线分析结果显示，TP、ALB、NLR的曲线下面积分别为0.532、0.659、0.875，其中NLR灵敏度、特异度均高于TP、ALB（P<0.05）。结论：术前高NLR患者TAPP术后血清肿发生率明显升高，NLR可作为预测TAPP术后血清肿发生的有效指标，从而为临床治疗提供有效参考。

【关键词】 中性粒细胞/淋巴细胞比值 腹腔镜 腹膜前疝修补术 血清肿

Correlation between Preoperative Neutrophil/Lymphocyte Ratio and Seroma after Transabdominal Preperitoneal Prosthesis/ZHAO Hangyu， WANG Yaohui. //Medical Innovation of China， 2021， 18（28）： -125

[Abstract] Objective： To analyze the correlation between preoperative neutrophil/lymphocyte ratio （NLR） and postoperative seroma after transabdominal preperitoneal prosthesis （TAPP）. Method： A total of 250 patients with inguinal hernia who were diagnosed and treated with TAPP in our hospital from June 2019 to June 2020 were selected. According to the occurrence of postoperative seroma， the patients were divided into seroma group and non-seroma group. logistic regression was used to analyze the influencing factors of postoperative seroma of TAPP. Preoperative serum indicators （TP， ALB and NLR levels） were detected in all patients， and the predictive value of preoperative serological indicators for postoperative TAPP seroma was evaluated by drawing receiver operating characteristic curve （ROC） and area under curve （AUC）. Result： Seroma occurred in 25 of the 250 patients （10.00%）. The levels of TP and ALB in seroma group were lower than those in non-seroma group， while NLR was higher than that in non-seroma group （P<0.05）. There were statistically significant differences in diameter of the hernia sac， course of disease， intraoperative blood loss and NLR between the two groups （P<0.05）. Multivariate logistic regression analysis showed that the diameter of the hernia sac， intraoperative blood loss and NLR were all influential factors for the occurrence of seroma after TAPP （P<0.05）. ROC curve analysis showed that the areas under ROC curve of TP， ALB and NLR were 0.532， 0.659 and 0.875， respectively， and the sensitivity and specificity of NLR were higher than those of TP and ALB （P<0.05）. Conclusion： The incidence of seroma in patients with preoperative high NLR after TAPP is significantly increased. NLR can be used as an effective index to predict the occurrence of seroma after TAPP， so as to provide an effective reference for clinical treatment.

[Key words] Neutrophil/lymphocyte ratio Laparoscopy Preperitoneal hernia repair Seroma

First-author’s address： Fushun Central Hospital， Fushun 113006， China

doi：10.3969/j.issn.1674-4985.2021.28.030

腹腔镜腹膜前疝修补术（TAPP）是目前临床用于治疗腹股沟疝的常用治疗方式之一，虽具有康复快、创伤小以及复发率低等优势，但仍有部分患者术后出现血清肿等并发症，从而影响患者治疗效果[1-2]。因此，如何早期预测TAPP术后血清肿的发生并给予治疗是目前重要方向。中性粒细胞/淋巴细胞比值（NLR）是目前临床评估肿瘤疾病复发以及预后生存的有效指标[3-4]。……