颈椎退行性疾病前路减压融合术中大量失血危险因素分析  

Risk factors of significant intraoperative blood loss during anterior cervical decompression and fusion for cervical degenerative diseases

作　　者：赵鑫源 郑滨 顾洪闻 项良碧 于海龙 李毅[1] 唐佩福[1] ZHAO Xin-yuan;ZHENG Bin;GU Hong-wen;XIANG Liang-bi;YU Hai-long;LI Yi;TANG Pei-fu(Department of Orthopedic Medicine,PLA General Hospital,Beijing 100000,China;Department of Orthopaedics,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]解放军总医院骨科医学部,北京100000 [2]北部战区总医院骨科,辽宁沈阳110016

出　　处：《临床军医杂志》2025年第2期144-146,150,共4页Clinical Journal of Medical Officers

基　　金：辽宁省科技计划联合计划项目(2023JH2-101700130)。

摘　　要：目的探讨颈椎退行性疾病前路减压融合术出现术中大量失血(SIBL)的危险因素。方法回顾性分析北部战区总医院自2015年1月至2019年12月收治的因颈椎退行性疾病行颈椎前路减压融合术的820例患者的临床资料。根据患者是否发生SIBL将患者分入SIBL组和无SIBL组。比较两组患者的临床资料并采用Logistic回归分析颈椎退行性疾病患者行颈椎前路减压融合术发生SIBL的影响因素。结果发生SIBL 20例(SIBL组),未发生SIBL 800例(无SIBL组),SIBL发生率为2.439%(20/820)。女性、合并肺部疾病、次全切除椎体1~2个、手术时间≥150 min、C3受累、手术节段存在后纵韧带骨化是颈椎退行性疾病患者行颈椎前路减压融合术发生SIBL的独立危险因素(P<0.05)。结论女性、合并肺部疾病、次全切除椎体1~2个、手术时间≥150 min、C3受累、手术节段存在后纵韧带骨化是颈椎退行性疾病患者行颈椎前路减压融合术发生SIBL的独立危险因素。Objective To investigate the risk factors of significant intraoperative blood loss(SIBL)during anterior cervical decompression and fusion for cervical degenerative diseases.Methods The clinical data of 820 patients who underwent anterior cervical decompression and fusion due to cervical degenerative diseases from January 2015 to December 2019 in General Hospital of Northern Theater Command were retrospectively analyzed.Patients were divided into groups with or without SIBL based on whether they developed SIBL.The clinical data of the two groups were compared.Logistic regression was used to analyze the influencing factors of SIBL in patients with cervical degenerative diseases who underwent anterior cervical decompression and fusion.Results There were 20 cases with SIBL(SIBL group)and 800 cases without SIBL(without SIBL group).The incidence of SIBL was 2.439%(20/820).Female,pulmonary disease,subtotal resection of one or two vertebrae,operation time≥150 minutes,C3 involvement and posterior longitudinal ligament ossification in the operative segment were independent risk factors for SIBL in patients with cervical degenerative diseases undergoing anterior cervical decompression and fusion(P<0.05).Conclusion Female,pulmonary disease,subtotal resection of one or two vertebrae,operation time≥150 minutes,C3 involvement and posterior longitudinal ligament ossification in the operative segment are independent risk factors for SIBL in patients with cervical degenerative diseases undergoing anterior cervical decompression and fusion.

关 键 词：颈椎前路减压融合术 颈椎退行性疾病 术中大量失血 危险因素 

分 类 号：R681.55[医药卫生—骨科学]