机器人辅助下经皮空心螺钉内固定治疗跟骨骨折术后并发症影响因素及模型预测分析  

Influencing factors to the postoperative complications of robotassisted percutaneous cannulated screw fixation in the treatment of calcaneal fracture and predictive model analysis

作　　者：杨东[1] 王家洪[1] 卿泉[1] 赵华桥[1] 李斌[1] YANG Dong;WANG Jiahong;QING Quan;ZHAO Huaqiao;LI Bin(Department of Foot and Ankle Orthopedic Surgery,Mianyang Orthopedic Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市骨科医院足踝科,四川绵阳621000

出　　处：《机器人外科学杂志（中英文）》2024年第5期777-782,共6页Chinese Journal of Robotic Surgery

基　　金：绵阳市哲学社会科学研究规划项目(MYZC2022064)。

摘　　要：目的:分析机器人辅助下经皮空心螺钉内固定治疗跟骨骨折术后并发症的影响因素并探讨其预测效能。方法:选取2018年3月—2023年12月于绵阳市骨科医院行机器人辅助下经皮空心螺钉内固定术的70例跟骨骨折患者作为研究对象。统计患者术后并发症发生情况,根据其是否出现并发症分为并发症发生组(发生组,26例)、无并发症组(未发生组,44例)。比较两组患者基本资料,采用单因素、多因素Logistic回归分析影响机器人辅助下经皮空心螺钉内固定治疗跟骨骨折术后并发症发生的因素,建立受试者工作特征曲线(ROC)分析相关影响因素预测术后并发症的效能。结果:与未发生组比较,发生组年龄≥50岁和有糖尿病占比更高,术后引流占比更低,受伤至就诊时间更长(P<0.05)。单因素、多因素结果显示,年龄、糖尿病、受伤至就诊时间、术后引流均为机器人辅助下经皮空心螺钉内固定治疗跟骨骨折术后并发症发生的相关影响因素(P<0.05)。影响因素联合预测模型Y=-1.849×年龄+1.882×糖尿病+0.482×受伤至就诊时间-1.809×术后引流-3.075,其预测术后并发症发生曲线下面积为0.865,标准误为0.046,置信区间为0.776~0.955,特异度为0.977,敏感度为0.692(P<0.05)。结论:年龄增加、存在糖尿病、受伤至就诊时间增加、术后不引流是机器人辅助下经皮空心螺钉内固定治疗跟骨骨折术后并发症发生的危险因素,基于此构建的预测模型预测效能较好,具备一定临床参考价值。Objective:To analyze the influencing factors to postoperative complications in the treatment of calcaneal fracture with robot-assisted percutaneous hollow screw fixation and its predictive efficacy.Methods:Clinical data of 70 patients with calcaneal fractures who underwent robot-assisted percutaneous cannulated screw fixation in Mianyang Orthopedic Hospital from March 2018 to December 2023 were collected.The occurrence of postoperative complications was recorded,and the patients were divided into the complication group(n=26)and the non-complication group(n=44)according to whether complications occurred or not.The basic information of the two groups was compared,and univariate and multivariate Logistic regression analyses were used to analyze the factors influencing the occurrence of postoperative complications after robotassisted percutaneous cannulated screw fixation for calcaneal fractures.A receiver operating characteristic curve(ROC)was established to analyze the effectiveness of influencing factors in predicting postoperative complications.Results:Compared with the non-complication group,the complication group had a higher proportion of patients aged 50 and above,a higher proportion of patients with diabetes,a lower proportion of patients receiving postoperative drainage,and a longer time from injury to doctor visit(P<0.05).The results of univariate and multivariate analyzing results showed that age,diabetes,time from injury to doctor visit,and postoperative drainage were all influencing factors to postoperative complications after robot-assisted percutaneous cannulated screw fixation for calcaneal fractures(P<0.05).The joint prediction model of influencing factors was Y=-1.849×age+1.882×diabetes+0.482×time from injury to doctor visit-1.809×postoperative drainage-3.075.The area under the curve for predicting postoperative complications was 0.865,with a standard error of 0.046,a confidence interval of 0.776~0.955,a specificity of 0.977,and a sensitivity of 0.692(P<0.05).Conclusion:Aging,diabetes mellitus,

关 键 词：机器人辅助手术 内固定 跟骨骨折 并发症 影响因素 

分 类 号：R658.3[医药卫生—外科学] R683.42[医药卫生—临床医学]