摘要
目的:分析后路长节段固定治疗成人退变性脊柱侧凸(ADS)围手术期并发症的发生率和风险因素,为术前风险分层提供参考。方法:选择性纳入2015年1月—2021年12月于我院采用传统后路开放手术进行长节段内固定融合术治疗的ADS患者,收集病史和手术资料,采用单因素分析筛选变量、多因素回归分析建立预测模型并绘制ROC曲线评价预测效率。结果:本研究共纳入162例患者,35例(21.60%)在围手术期发生并发症。单因素分析显示合并心脏病、合并贫血、手术史、术中神经减压、术中脊柱截骨、术前Cobb角是围手术期并发症的风险因素(P<0.05);多因素回归分析显示美国麻醉医师协会(ASA)分级和脊柱截骨是围手术期并发症的独立风险因素(P<0.05),其中脊柱截骨同时是主要并发症和轻微并发症的独立风险因素(P<0.01)。结论:ASA分级≥2级和术中实施脊柱截骨是后路长节段固定治疗成人退变性脊柱侧凸围手术期并发症的独立风险因素。识别危险因素有助于术前风险分层和减少并发症的发生。
Objective:To analyze the incidence and risk factors of perioperative complications in the treat-ment of adult degenerative scoliosis(ADS)with posterior long segment fixation in order to provide reference for preoperative risk stratification and reduce the occurrence of complications.Methods:Patients with ADS who underwent long segment internal fixation and fusion with traditional posterior open surgery in our hospi-tal from January 2015 to December 2021 were selectively enrolled.The medical history and surgical data were collected.Univariate analysis and multivariate regression analysis were used to establish a predictive mod-el and draw a ROC curve to evaluate the predictive efficiency.Results:A total of 162 patients were included in this study,35 cases(21.60%)had perioperative complications.Univariate analysis showed that heart disease,anemia,surgical history,intraoperative neurodecompression,intraoperative spinal osteotomy and preoperative Cobb angle were risk factors for perioperative complications(P<0.05).Multivariate regression analysis showed that the American Society of Anesthesiologists(ASA)grade and spinal osteotomy were the risk factors for peri-operative complications(P<0.05),while spinal osteotomy is both the independent risk factor for major compli-cations and minor complications(P<0.01).Conclusion:Our study shows that ASA grade≥2 and intraoperative spinal osteotomy are independent risk factors for perioperative complications of posterior long segmental fixa-tion in the treatment of adult degenerative scoliosis.The identification of risk factors is helpful to preoperative risk stratification and reduce the occurrence of complications.
出处
《中日友好医院学报》
CAS
2023年第6期328-332,381,共6页
Journal of China-Japan Friendship Hospital
基金
海南省卫生计生行业科研项目(20A200352)。
关键词
成人退变性脊柱侧凸
围手术期并发症
后路长节段固定
回顾性研究
风险因素
adult degenerative scoliosis
perioperative complications
posterior long segmental fixation
retro-spective study
risk factors
