先天性脊柱侧凸后路融合内固定术后肺部并发症的危险因素分析  

Risk factors for pulmonary complications after posterior spinal instrumentation and fusion in treatment of congenital scoliosis

作　　者：吴磊[1] 海涌[2] WU Lei;HAI Yong(Department of Orthopedics,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院骨科,北京100080 [2]北京朝阳医院骨科

出　　处：《中国骨与关节损伤杂志》2021年第5期461-464,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨先天性脊柱侧凸后路融合内固定术后出现肺部并发症的危险因素。方法回顾性分析自2012-01—2017-12采用后路融合内固定治疗的276例先天性脊柱侧凸,39例后路融合内固定术后出现肺部并发症(观察组),237例后路融合内固定术后未出现肺部并发症(对照组)。分析先天性脊柱侧凸后路融合内固定术后出现肺部并发症的危险因素。结果单因素分析结果显示2组在年龄、性别、病史时间、再手术数、术前肺部疾病、主弯位置、术前侧凸Cobb角、侧凸Cobb角矫正率、椎体融合节段、上胸椎置钉、中胸椎置钉、下胸椎置钉、胸廓成形、手术时间、输血量、RV/TLC比较差异有统计学意义(P<0.05),多因素Logistic回归分析结果显示年龄、再手术、术前合并肺部疾病、侧凸Cobb角矫正率、中胸段置钉和胸廓成形术是先天性脊柱侧凸后路融合内固定术后出现肺部并发症的危险因素。结论年龄、术前肺部疾病、再手术、侧凸Cobb角矫形率、中胸椎螺钉固定、胸廓成形术是先天性脊柱侧凸后路融合内固定术后出现肺部并发症的危险因素。Objective To investigate the risk factors for pulmonary complications after posterior spinal instrumentation and fusion in the treatment of congenital scoliosis.Methods Two hundred and seventy six cases of congenital scoliosis treated with posterior fusion and internal fixation from January 2012 to December 2017 were retrospectively analyzed, including 39 cases of pulmonary complications after posterior fusion and internal fixation(observation group), and 237 patients without pulmonary complications after fusion and internal fixation(control group). The risk factors of pulmonary complications after posterior fusion and internal fixation of congenital scoliosis were analyzed.ResultsThe results of univariate analysis showed that there were statistically significant differences between the two groups in age, gender, medical history, reoperation patients, preoperative lung disease, main curve position, preoperative scoliosis Cobb angle, scoliosis Cobb angle correction rate, vertebral body fusion segment, upper thoracic spine nail, middle thoracic spine in nail placement, lower thoracic spine nail placement, thoracic formation, operation time, blood transfusion, and RV/TLC(P<0.05). Multivariate logistic regression analysis showed age, reoperation,preoperative lung disease, correction rate of scoliosis Cobb angle, middle thoracic nail placement and thoracoplasty were risk factors for pulmonary complications after posterior fusion and internal fixation of congenital scoliosis.ConclusionAge, preoperative lung disease, reoperation, lower correction rate of scoliosis Cobb angle, middle thoracic spine screw fixation, and thoraplasty are risk factors for pulmonary complications after posterior fusion and internal fixation of congenital scoliosis.

关 键 词：先天性脊柱侧凸 后路融合内固定 肺部并发症 LOGISTIC回归分析 

分 类 号：R687.3[医药卫生—骨科学]