颈椎再次手术风险因素和原因分析  

Risk factors and causes analysis of cervical spinal reoperation

作　　者：李穗鸥 刘少喻[1] 王乐[1] 钟锐[1] 魏富鑫[1] 崔尚斌[1] LI Suiou LIU Shaoyu WANG Le ZHONG Rui WEI Fuxin CUI Shangbin(Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China)

机构地区：[1]中山大学附属第一医院脊柱外科,广州510080

出　　处：《岭南现代临床外科》2017年第1期84-88,共5页Lingnan Modern Clinics in Surgery

摘　　要：目的本文通过回顾性分析颈椎手术病例再次手术情况,分析颈椎再次手术的风险因素和原因。方法回顾性分析中山大学附属第一医院2005年5月至2015年5月所行颈椎手术患者共1043例,其中颈椎再次手术56例;记录患者性别、年龄、住院天数、手术节段、手术入路、是否内固定、手术出血量、手术时间、第一次手术术前诊断、第一次手术前白细胞数值以及中性粒细胞百分比,使用SPSS软件,进行统计学分析。结果经二元Logistics回归分析,住院天数、白细胞数值和术中出血量是颈椎再次手术的重要风险因素。脊髓再次受压、肿瘤复发、伤口不愈合是颈椎再次手术的主要原因。结论对于具有相关风险因素的患者,除了告知颈椎再次手术高风险外,还可以规范肿瘤术后放化疗,密切观察伤口情况,适时复查感染指标,加强宣教术后制动和佩戴颈围保护,努力降低再手术发生率。Objective To investigate the risk factors and causes of cervical reoperation.Methods From May 2005 to May 2015 in the First Affiliated Hospital of Sun Yat-sen University,1043 cases received cervical surgeries,among which 56 cases received reoperation. We recorded the patients′gender,age,hospitalization days,surgery segment,surgery approach,with internal fixation or not,surgical blood loss,surgery duration,pre-operative diagnosis,WBC levels and the neutrophil percentagebefore the first operation. The statistical analysis was carried out with software SPSS. Results Usinglogistic regression analysis,we found that the hospitalization days,WBC levels before the first operationand surgical blood loss were the important risk factors of cervical reoperation. Spinal cord recompression,tumor recurrence and nonhealing wounds were the major causes of cervical reoperation. Conclusion Forpatients with associated risk factors,they should be informed about the high risk of cervical reoperation,the doctors may also need to regulate tumor radiation and chemotherapy,observe the postoperativewounds more frequently,review indicators of infection timely and limit the postoperative cervical activityby wearing a neck circumference,so as to reduce the incidence of cervical reoperation.

关 键 词：风险因素 颈椎再次手术 颈椎再手术原因 

分 类 号：R681.5[医药卫生—骨科学]