腰椎间盘切除术后1年内非计划再入院影响因素分析  

Analysis of influencing factors of unplanned readmission within 1 year after lumbar discectomy

作　　者：曾贞[1] 李静[1] 赵冬梅[1] 李鹏程[1] ZENG Zhen;LI Jing;ZHAO Dong-mei;LI Peng-cheng(Orthopaedic Sports Medicine Institute,West China Hospital,Sichuan University,Chengdu,Sichuan 610000,China)

机构地区：[1]四川大学华西医院骨科运动医学中心,四川成都610000

出　　处：《颈腰痛杂志》2020年第4期420-422,425,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：四川省科学技术厅项目(编号:2017SZ0046)。

摘　　要：目的探讨腰椎间盘切除术后1年内非计划再入院的影响因素,为其预防提供理论依据。方法纳入2015年10月-2018年10月于本院接受经皮内窥镜下腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)的患者167例,随访1年,其中13例于术后1年内非计划再入院,设为观察组;余154例患者设为对照组。收集两组患者临床资料,采取单因素分析和多因素Logistic回归分析确定术后1年内非计划再入院的独立危险因素。结果两组患者在性别、吸烟史、高血压史、冠心病史、慢性肾脏疾病史、椎间盘突出分型、腰椎失稳、手术时间、术后住院时间等方面比较,差异无统计学意义(P>0.05);在年龄、BMI指数、饮酒史、糖尿病史、慢性呼吸道疾病史等方面比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≥55岁(OR=1.852)、BMI指数≥24 kg/m^ 2(OR=1.541)、糖尿病史(OR=7.620)是腰椎间盘切除术后1年内非计划再入院的独立危险因素(P<0.05)。结论年龄≥55岁、BMI指数≥24 kg/m^ 2、合并糖尿病的PELD患者,术后1年内非计划再入院的概率较高,临床应加以重视。Objective To explore the influencing factors of unplanned readmission within 1 year after lumbar discectomy,and to provide the theoretical basis for its prevention. Methods A total of 167 patients who underwent percutaneous endoscopic lumbar discectomy( PELD) in our hospital from October 2015 to October 2018 were included in this study. All patients were followed up for 1 year,and 13 patients were with unplanned readmission within 1 year after surgery and were set as observation group. The remaining 154 patients were set as control group. The clinical data of the two groups were collected. Univariate and multivariate Logistic regression analysis were used to determine the independent risk factors for unplanned readmission within 1 year after surgery. Results There were no significant differences in gender,smoking history,history of hypertension,history of coronary heart disease,history of chronic kidney disease,disc herniation types,lumbar instability,operative time and postoperative hospital stay between the two groups( P > 0. 05).There were statistically significant differences in the age,BMI index,drinking history,diabetes mellitus history,chronic respiratory disease history and other aspects( P<0.05). Multivariate Logistic regression analysis showed that age≥55 years old( OR = 1.852),BMI index≥24 kg/m^2( OR= 1.541) and diabetes mellitus history( OR= 7.620) were risk factors for planned readmission within 1 year after lumbar discectomy( P<0.05). Conclusion The probability of unplanned readmission within 1 year after surgery is higher among PELD patients with age≥55 years old,BMI≥24 kg/m^2 and diabetes mellitus,and it is necessary to pay attention to these patients in clinical practice.

关 键 词：腰椎间盘切除术 非计划再入院 危险因素 BMI指数 糖尿病 

分 类 号：R681.53[医药卫生—骨科学]