| 郁有来,潘 彬,张 驰,邓 斌,孙玛骥.成人脊柱畸形患者矫正术后力学性并发症发生率及其危险因素分析[J].,2022,(10):1904-1908 |
| 成人脊柱畸形患者矫正术后力学性并发症发生率及其危险因素分析 |
| Analysis of the Incidence of Mechanical Complications and Risk Factors in Adult Patients with Spinal Deformity after Correction |
| 投稿时间：2021-10-09 修订日期：2021-10-31 |
| DOI：10.13241/j.cnki.pmb.2022.10.022 |
| 中文关键词: 脊柱畸形矫正术 力学性并发症 危险因素 |
| 英文关键词: Spine deformity correction surgery Mechanical complications Risk factors |
| 基金项目:国家自然科学基金青年项目（81801213） |
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| 中文摘要: |
| 摘要 目的：研究成人脊柱畸形患者矫正手术后力学性并发症的发生率以及影响其发生的危险因素。方法：纳入2016年6月到2020年6月在我院接受脊柱畸形矫正术的患者80例，术后对所有患者进行为期12个月的随访。根据患者术后随访期间是否出现力学性并发症分为力学并发症组和无力学并发症组，调查两组患者年龄、BMI、术中失血量、手术时间、合并神经损伤、术中截骨、性别、主弯角度、矫正率、手术史、入路以及疾病类型等病历资料，并通过单因素和多因素Logistic回归分析成人脊柱畸形矫正术后发生力学性并发症的独立危险因素。结果：80例脊柱畸形矫正术患者术后发生力学性并发症患者18例（22.50 %），分别为内固定失败4例、近端交界性失败5例、远端交界性失败4例以及术后冠状面失平衡5例。单因素分析结果表明，手术时间（OR=6.924，P=0.015）、年龄（OR=2.803，P=0.011）、矫正率（OR=3.215，P=0.032）、合并神经损伤（OR=1.629，P=0.021）、术中截骨术（OR=5.876，P=0.005）以及手术史（OR=1.692，P=0.043）与成人脊柱畸形矫正术后力学性并发症的发生有关。多因素Logistic回归分析结果表明，手术时间（OR=2.265，P=0.002）、年龄（OR=4.035，P<0.001）、合并神经损伤（OR=3.024，P=0.003）以及术中截骨术（OR=3.982，P<0.001）是成人脊柱畸形矫正术后发生力学性并发症的独立危险因素。结论：成年脊柱畸形患者矫正术后易发生力学性并发症，手术时间较长、年龄较大、合并神经损伤以及术中截骨术均会增加其发生风险。 |
| 英文摘要: |
| ABSTRACT Objective: To study the incidence of mechanical complications in adult patients with spinal deformity after corrective surgery and the risk factors that affect their occurrence. Methods: Eighty patients who underwent spinal deformity correction surgery in our hospital from June 2016 to June 2020 were included. All patients were followed up for 12 months after the operation. According to whether the patients have mechanical complications during the postoperative follow-up, they are divided into mechanical complication group and non-mechanical complication group. We investigated the medical history data of the two groups of patients such as age, BMI, intraoperative blood loss, operation time, combined nerve injury, intraoperative osteotomy, gender, main curve angle, correction rate, surgical history, surgical approach, and disease type. And we used univariate and multivariate Logistic regression analysis to determine the independent risk factors for mechanical complications after adult spinal deformity correction. Results: Mechanical complications occurred in 18 patients (22.50 %) of the 80 patients after spinal deformity correction, including 4 internal fixation failures, 5 proximal junctional filure, 4 distal junctional filure and 5 postoperative coronal plane imbalance. Univariate analysis showed that operative time (OR=6.924, P=0.015), age (OR=2.803, P=0.011), correction rate (OR=3.215, P=0.032), combined nerve injury (OR=1.629, P=0.021), intraoperative osteotomy (OR=5.876, P=0.005) and surgical history (OR=1.692, P=0.043) were associated with mechanical complications after spinal deformity correction in adults. Multivariate Logistic regression analysis showed that operative time (OR=2.265, P=0.002), age (OR=4.035, P<0.001), combined nerve injury (OR=3.024, P=0.003), and intraoperative osteotomy (OR=3.982, P<0.001) was an independent risk factor for mechanical complications after spinal deformity correction in adults. Conclusion: Adult patients with spinal deformity are prone to mechanical complications after correction. Long operation time, eld, combined nerve injury, and intraoperative osteotomy all increase their risk. |
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