摘要
目的研究脊柱侧凸畸形行全脊椎截骨术后大量引流情况,并分析其危险因素。方法纳入2013-08-2018-01,于我院采用全脊椎截骨术治疗的145例脊柱侧凸畸形患者,根据术后引流量/估计血容量比例,将≤30%者设为正常引流量组,>30%者设为大量引流量组。统计两组患者术前Cobb角、手术节段、年龄、性别等病历资料,经单因素与多因素分析,调查脊柱侧凸畸形全脊椎截骨术后大量引流的独立危险因素。结果 145例患者术后出现大量引流56例,发生率38.62%,平均引流量(1037.34±148.34)ml;正常引流量组平均引流量(632.24±108.21)ml。组间术前Cobb角、手术节段、术前血小板计数(PLT)、术中输血量、身体质量指数(Body Mass Index, BMI)、术前美国麻醉医师协会(ASA)分级、畸形类型、置钉数、手术时间差异有统计学意义(P<0.05),性别、年龄、住院时间、术后输血差异无统计学意义(P>0.05);多因素Logistic回归分析显示,术前Cobb角≥55°(OR=3.657,95%CI:1.154～12.432)、手术节段>10(OR=3.256,95%CI:1.128～11.213)、术前PLT<190×109/L(OR=3.041,95%CI:1.231～10.082)、术中输血≥19.55 ml/kg(OR=2.976,95%CI:1.215～9.656)是脊柱侧凸畸形全脊椎截骨术后大量引流的独立危险因素。结论脊柱侧凸畸形全脊椎截骨术后容易出现大量引流情况,术前Cobb角≥55°、手术节段>10、术前PLT<190×109/L、术中输血≥19.55 ml/kg均会增加其发生风险。
Objective To study the situation of massive drainage after total vertebral osteotomy in the treatment of scoliosis deformity and analyze the risk factors. Methods A total of 145 patients with scoliosis who underwent total vertebroplasty in our hospital from August 2013 to January 2018 were enrolled in this study. According to postoperative drainage/estimated blood volume ≤30% and > 30%, they were set as the normal drainage group and the large drainage group. The preoperative Cobb angle, surgical segment, age, gender and other medical records were collected from the two groups. The single-factor and multi-factor analysis was used to investigate the independent risk factors of a large number of drainage after total vertebral osteotomy in the treatment of scoliosis deformity. Results A total of 145 patients had a large number of drainage after operation in 56 cases, the incidence rate was 38.62%,the mean drainage volume(1037.34±148.34) ml, the average drainage volume of the normal drainage group(632.24±108.21) ml;the preoperative Cobb angle between the groups, the surgical segment Preoperative platelet count(PLT), intraoperative blood transfusion,body mass index(BMI), preoperative American Society of Anesthesiologists(ASA) classification, type of deformity, number of nails, and time difference were statistically significant(P <0.05), there was no significant difference in gender, age, hospitalization time and postoperative blood transfusion(P >0.05). Multivariate logistic regression analysis showed preoperative Cobb angle ≥55°(OR =3.657,95%CI:1.154~12.432), surgical segment >10(OR=3.256,95%CI:1.128~11.213), preoperative PLT<190×109/L(OR=3.041,95%CI:1.231~10.082), intraoperative blood transfusion ≥19.55 ml/kg(OR=2.976, 95%CI:1.215~9.656) were the independent risk factor for massive drainage after total vertebral osteotomy. Conclusion Spine scoliosis is prone to a large number of drainage after total vertebroplasty. Preoperative Cobb angle ≥55°, surgical segment >10, preoperative PLT<190×109/L, intraoperative blood transfusion ≥19.55 ml/kg can increase its risk.
作者
张力
ZHANG Li(Department of Orthopaedics, Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine, Panzhihua,Sichuan Province,617000,China)
出处
《颈腰痛杂志》
2019年第2期188-190,共3页
The Journal of Cervicodynia and Lumbodynia
