急性创伤性颈脊髓损伤术后继发神经源性休克危险因素及预测效能分析  

Risk factors and predictive efficacy of secondary neurogenic shock of patients with acute traumatic cervical spinal cord injury after surgery

作　　者：朱晓凤 尉国莲 姚丹华 金叶霞 盛娇娇 ZHU Xiaofeng;WEI Guolian;YAO Danhua(Jiaxing Second Hospital,Zhejiang 314000,China)

机构地区：[1]浙江省嘉兴市第二医院,嘉兴314000

出　　处：《浙江创伤外科》2024年第4期603-605,609,共4页Zhejiang Journal of Traumatic Surgery

基　　金：2022年嘉兴市公益性研究计划项目(2022AD30014)。

摘　　要：目的 探讨急性创伤性颈脊髓损伤术后继发神经源性休克危险因素并进一步分析相关因素临床预测效能。方法 回顾性纳入2021年6月至2023年6月于本院行手术治疗急性创伤性颈脊髓损伤患者共100例,根据术后是否继发神经源性休克分为休克组(39例)和非休克组(61例);采用单因素和多因素法评估急性创伤性颈脊髓损伤术后继发神经源性休克独立危险因素;描绘ROC曲线分析上述独立危险因素用于急性创伤性颈脊髓损伤术后继发神经源性休克风险预测临床效能。结果 本研究纳入于本院行手术治疗急性创伤性颈脊髓损伤患者共100例,术后继发神经源性休克39例,发生率为39.00%;单因素分析结果显示,是否存在低钠血症、美国脊髓损伤协会损伤分级及24 h尿量均可能与急性创伤性颈脊髓损伤术后继发神经源性休克有关(P<0.05);多因素分析结果显示,低钠血症、美国脊髓损伤协会损伤分级A级及24 h尿量增多均是急性创伤性颈脊髓损伤术后继发神经源性休克独立危险因素(P<0.05);ROC曲线分析结果显示,是否存在低钠血症、美国脊髓损伤协会损伤分级及24 h尿量均可用于急性创伤性颈脊髓损伤术后继发神经源性休克风险预测,且三种指标联合预测效能均显著高于单一指标(P<0.05)。结论 急性创伤性颈脊髓损伤术后继发神经源性休克与是否存在低钠血症、美国脊髓损伤协会损伤分级及24 h尿量关系密切;而上述指标联合在预测术后继发神经源性休克风险方面显示出更佳效能。Objective To explore the risk factors and predictive efficacy of secondary neurogenic shock of patients with acute traumatic cer-vical spinal cord injury after surgery.Methods 100 patients with acute traumatic cervical spinal cord injury who underwent surgery in our hospital from June 2021 to June 2023 were retrospectively studied,including shock group(39 cases) and non-shock group(61 cases) according to whether neurogenic shock occurred after surgery.The independent risk factors of secondary neurogenic shock after acute traumatic cervical spinal cord injury were evaluated by univariate and multivariate method.ROC curves were drawn to analyze the clinical efficacy of above independent risk factors in predicting of secondary neurogenic shock risk of patients with acute traumatic cervical spinal cord after surgery.Results There were 39 patients suffered from secondary neurogenic shock after surgery in all 100 patients with acute traumatic cervical spinal cord injury underwent surgery in our hospital were included in this study for incidence of 39.00%.Univariate analysis showed that the presence or absence of hyponatremia,American Spinal cord Injury Association injury grade and 24 h urine volume may be associated with secondary neurogenic shock of patients with acute traumatic cervical spinal cord injury after surgery(P <0.05).Multivariate analysis showed that hyponatremia,American Spinal Cord Injury Association injury Grade A and 24 h increased urine volume were independent risk factors for secondary neurogenic shock of patients with acute traumatic cervical spinal cord injury after surgery(P<0.05).ROC curve analysis showed that the presence or absence of hyponatremia,American Spinal cord Injury Asso-ciation injury grade and 24 h urine volume could be used to predict of secondary neurogenic shock risk of patients with acute traumatic cervical spinal cord injury after surgery,and the combined prediction efficiency of above three indicators was significantly higher than single indicator( P<0.05).Conclusion Secondary

关 键 词：急性创伤性颈脊髓损伤 手术 神经源性休克 危险因素 

分 类 号：R651.1[医药卫生—外科学]