颈椎手术后出现吞咽困难的相关因素分析  

Risk factors of dysphagia following cervical spine surgery

作　　者：陶晓晖[1] 田伟[1] 刘波[1] 李勤[1] 张贵林[1] 

机构地区：[1]北京大学第四临床医学院 北京积水潭医院,北京100035

出　　处：《山东医药》2013年第48期19-21,共3页Shandong Medical Journal

摘　　要：目的分析颈椎前路及后路手术后出现吞咽困难的相关因素。方法颈椎手术患者354例,其中行颈椎前路手术172例(AC组),颈椎后路手术182例(PC组);术后随访平均28个月,了解患者术后当天及1、3、6、12个月吞咽困难发生情况。采用单因素及二元Logistic回归模型,分析患者临床资料与与吞咽困难发生的关系。结果两组术后各时点吞咽困难发生率及严重程度比较,P均>0.05。单因素分析结果显示,两组吞咽困难发生均与年龄、性别、BMI、翻修手术比例、手术时间、出血量无关,P均>0.05。二元Logistic回归分析结果显示,性别、年龄、BMI、手术方式(AC或PC)、手术节段数目、最高手术节段水平、翻修手术比例、手术时间、出血量等与术后吞咽困难的发生无显著关联,P均>0.05。结论颈椎手术后吞咽困难的发生不受患者性别、年龄、BMI、手术时间、出血量、手术方式、翻修手术比例、手术节段数目、最高手术节段水平等因素的影响。Objective To analyze the incidence and risk factors of dysphagia after anterior and posterior cervical spine surgeries （AC and PC procedures）. Methods Three hundred and fifty-four patients were reviewed in this study, inclu- ding 172 patients undergoing AC procedure （AC group）, and 182 patients with PC procedure （PC group）. All patients were followed up for 28 months. The presence and severity of dysphagia were reported on the first day of surgery and at 1, 3, 6 and t2 months after the procedure. The incidence and risk factors of dysphagia after cervical spine surgery were stud- ied by using univariate and binary Logistic regression model analysis. Results The incidence and risk factors of dysphagia after cervical spine surgery at different time points were not statistically significant between the two groups （ all P 〉 0.05 ）. The univariate and binary Logistic regression model analysis showed that the risk factors such as age, gender, BMI, opera- tive time, blood loss, procedure type, revision surgery, most cephalic operative level and number of operative levels did not significantly influence the incidence of postoperative dysphagia in the two groups （ all P 〉 0.05 ）. Conclusions Postopera- tive dysphagia is common after anterior and posterior cervical spine surgery. The incidence and severity of dysphagia both decrease over time. Age, gender, BMI, operative time, blood loss, procedure type, revision surgery, most cephalic opera- tive level and number of operative levels may not be risk factors of postoperative dysphagia.

关 键 词：颈椎手术 颈椎前路手术 颈椎后路手术 吞咽困难 

分 类 号：R681.5[医药卫生—骨科学]