[1]宋建东 李停 李长文 徐红辉 陈子健 桑大伟 黄帅.脊柱侧凸后路三维矫形术围手术期并发症的危险因素及其预防策略[J].中国中医骨伤科杂志,2017,25(10):38-40,43.
 SONG Jiandong LI Ting LI Changwen XU HonghuiCHEN Zijian SANG Dawei HUANG Shuai.Risk Factors and Prevention Strategies for Perioperative Complications of Posterior Three-dimensional Correction of Scoliosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(10):38-40,43.
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脊柱侧凸后路三维矫形术围手术期并发症的危险因素及其预防策略()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年10期
页码:
38-40,43
栏目:
临床论著
出版日期:
2017-10-15

文章信息/Info

Title:
Risk Factors and Prevention Strategies for Perioperative Complications of Posterior Three-dimensional Correction of Scoliosis
文章编号:
1005-0205(2017)10-0038-03
作者:
宋建东1 李停1 李长文1 徐红辉1 陈子健1 桑大伟1 黄帅1
1湖北省中西医结合医院骨科(武汉,430015)
Author(s):
SONG Jiandong1 LI Ting1 LI Changwen1 XU Honghui1CHEN Zijian1 SANG Dawei1 HUANG Shuai1
1Department of Orthopedics, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan 430015, China.
关键词:
脊柱侧凸 三维矫形术 围手术期干预 并发症 危险因素
Keywords:
Keywords: scoliosis three-dimensional correction perioperative intervention complications risk factors
分类号:
R681.5
文献标志码:
A
摘要:
目的:评估脊柱侧凸后路三维矫形术并发症的危险因素及其预防策略。方法:本研究纳入2005年10月至2015年1月期间本院骨科所收治的接受脊柱侧凸后路三维矫形术的患者186例。回顾性分析患者的人口学数据、手术资料及并发症的发生情况。通过单因素分析临床因素与并发症发生的相关性,并采用多因素Logistic回归模型分析有统计学意义的指标。另外,回顾性分析预防策略及其临床效果。结果:在186例患者中出现围手术期并发症55例次,其中5例(2.69%)患者术后出现伤口感染,26例(13.98%)术后出现切口延迟愈合,8例(4.30%)术后出现肺部感染,11例(5.91%)术后出现泌尿系感染,5例(2.69%)患者术后发生深静脉血栓。单因素分析结果显示年龄、性别、合并疾病、手术节段、手术时间与并发症的发生无相关性。多因素Logistic回归模型分析结果显示术中出血量是并发症发生的独立危险因素。采用围手术期预防性策略可以降低并发症的发生率。结论:脊柱侧凸后路三维矫形术最常见的并发症是切口延迟愈合和泌尿系感染。并发症的发生受多种因素影响,其中术中出血量是并发症发生的独立危险因素。采用围手术期预防性策略可以降低并发症的发生率。
Abstract:
Abstract Objective: To evaluate the risk factors and prevention strategies of postoperative three-dimensional correction of scoliosis. Methods: A total of 186 patients underwent three-dimensional correction of scoliosis from January 2014 to February 2015 were included in this study. The demographic data, surgical data and the incidence of complications of the patients were analyzed retrospectively. The correlation between clinical factors and complication was analyzed by univariate analysis, and multivariate logistic regression model was used to analyze the statistically significant indexes. In addition, the preventive strategies and their clinical effects were analyzed retrospectively. Results: Fifty-five patients(2.69%)had wound infection in 186 patients, and 26 cases(13.98%)had delayed incision after operation. Eight patients(4.30%)had pulmonary infection, 11 cases(5.91%)had postoperative urinary tract infection, and 5 cases(2.69%)had deep vein thrombosis after surgery. Univariate analysis showed that age, sex, combined disease, operative segment, operation time and the occurrence of complications were not related. Multivariate logistic regression analysis showed that intraoperative blood loss was an independent risk factor for complications. The use of perioperative preventive strategies can reduce the incidence of complications. Conclusion: The most common complications of posterior three-dimensional correction of scoliosis are delayed incision healing and urinary tract infection.The incidence of complications is affected by a variety of factors, and intraoperative blood loss is an independent risk factor for the occurrence of complications. The perioperative preventive strategies can reduce the incidence of complications.

参考文献/References:

[1] Dorward IG,Lenke LG,Stoker GE,et al.Radiographic and clinical outcomes of posterior column osteotomies in spinal deformity correction [J].Spine(Phila Pa 1976),2014,(Epub ahead of print).
[2] Lenke LG,Newton PO,Sucato DJ,et al.Complications after 147 consecutive vertebral column resections for severe pediatric spinal deformity:a multicenter analysis[J].Spine(Phila Pa 1976),2013,38(2):119-132.
[3] Pehrsson K,Danielsson A,Nachemson A.Pulmonary function in adolescent idiopathic scoliosis:a 25 year follow up after surgery or start of brace treatment[J].Thorax,2001,56(5):388-393.
[4] Yuan N,Fraire JA,Margetis MM,et al.The effect of scoliosis surgery on lung function in the immediate postoperative period[J].Spine(Phila Pa 1976),2005,30(19):2182-2185.
[5] 冯宾,邱贵兴,沈建雄,等.经颅刺激运动诱发电位联合体感诱发电位监测在脊柱畸形手术中的应用[J].中华骨科杂志,2012,32(1):13-19.
[6] 邵林,解京明,赵智.牵引在脊柱畸形中的应用回顾 [J].医学综述,2013,19(16):2946-2949.
[7] 邱勇,刘臻,朱锋,等.Halo-股骨髁上牵引对重度脊柱侧凸后路矫形的影响 [J].中华外科杂志.2007(8):513-516.
[8] 赵伟峰,周焯家,李波,等.脊柱后路手术术后感染的治疗探讨 [J].中华医院感染杂志,2013,23(16):922-925.
[9] 李明,顾苏熙,朱晓东,等.全节段椎弓根螺钉系统矫治青少年特发性胸腰椎/腰椎侧凸的疗效 [J].中国脊柱脊髓杂志,2007,17(4):261-265.
[10] Carreon LY,Puno RM,Dimar JR 2nd,et al.Perioperative complications of posterior lumbar decompression and arthrodesis in older adults [J].J Bone Joint Surg Am,2003,85(11):2089-2092.

更新日期/Last Update: 1900-01-01