儿童脊柱侧弯后路矫形术后并发症的危险因素

doi:10.16352/j.issn.1001-6325.2022.11.1755

基础医学与临床 ›› 2022, Vol. 42 ›› Issue (11): 1755-1759.doi: 10.16352/j.issn.1001-6325.2022.11.1755

儿童脊柱侧弯后路矫形术后并发症的危险因素

马满姣¹, 马璐璐^1*, 张秀华^1*, 仉建国², 沈建雄², 黄宇光¹

中国医学科学院北京协和医学院北京协和医院 1.麻醉科; 2.骨科, 北京 100730

收稿日期:2022-01-19 修回日期:2022-05-06 出版日期:2022-11-05 发布日期:2022-11-01
通讯作者: ^* malulu@pumch.cn; zhangxh@pumch.cn

Risk factors for postoperative complications in posterior scoliosis correction surgeries of pediatric patiens

MA Man-jiao¹, MA Lu-lu^1*, ZHANG Xiu-hua^1*, ZHANG Jian-guo², SHEN Jian-xiong², HUANG Yu-guang¹

1. Department of Anesthesiology; 2. Department of Orthopedics, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China

Received:2022-01-19 Revised:2022-05-06 Online:2022-11-05 Published:2022-11-01
Contact: ^* malulu@pumch.cn; zhangxh@pumch.cn

摘要/Abstract

摘要： 目的了解儿童脊柱侧弯后路矫形术后并发症发生率及其危险因素。方法为回顾性队列研究。收集2015年1月至2017年12月期间在北京协和医院行脊柱侧弯后路矫形手术的患儿围术期资料。根据术后是否发生并发症,将患者分为并发症组和无并发症组,比较两组的临床特征。用二分类Logistic回归分析其术后发生并发症的危险因素。结果 580例患者纳入研究,其术后并发症发生率为5.7%,危险因素为术前Cobb角＞69.5°(OR=3.043,95% CI: 1.436~6.448, P＜0.01)和围术期输注异体血(OR=2.364, 95% CI: 1.095~5.102, P＜0.05)。与无并发症组相比,并发症组患者术后返重症加强护理病房(ICU)率更高(P＜0.01)和住院时间更长(P＜0.001)。结论儿童脊柱侧弯后路矫形手术术后并发症发生的危险因素包括术前Cobb角＞69.5°和围术期输注异体血。

关键词: 脊柱侧弯, 后路矫形手术, 儿童, 并发症

Abstract: Objective To investigate the postoperative complication rate in pediatric patients who underwent posterior scoliosis correction surgeries, and to identify its risk factors. Methods This study was a retrospective cohort study. Anesthetic data of pediatric patients who underwent posterior scoliosis correction surgeries from January 2015 to December 2017 in Peking Union Medical College Hospital were collected and analyzed. The clinical variables were subsequently compared between patients in whom postoperative complication occured (complication group) and those in whom did not (non-complication group). Binary Logistic regression analysis was performed to identify risk factors of postoperative complication in these patients. Results The study enrolled 580 patients. The postoperative complication rate was 5.7% and the independent risk factors leading to it included preoperative Cobb angle larger than 69.5° (OR=3.043, 95% CI:1.436-6.448, P＜0.01) and perioperative allogeneic transfusion(OR=2.364, 95% CI:1.095-5.102, P＜0.05). The postoperative transfer rate to Intensive Care Unit(ICU)(P＜0.01) in complication group was higher, with longer hospital stay length (P＜0.001) than that in the non-complication group. Conclusions The risk factors for postoperative complication in pediatric patients receiving posterior scoliosis correction surgeries include preoperative Cobb angle larger than 69.5° and perioperative allogeneic transfusion.

Key words: scoliosis, posterior correction surgery, children, complication

中图分类号:

R687.3

马满姣, 马璐璐, 张秀华, 仉建国, 沈建雄, 黄宇光. 儿童脊柱侧弯后路矫形术后并发症的危险因素[J]. 基础医学与临床, 2022, 42(11): 1755-1759.

MA Man-jiao, MA Lu-lu, ZHANG Xiu-hua, ZHANG Jian-guo, SHEN Jian-xiong, HUANG Yu-guang. Risk factors for postoperative complications in posterior scoliosis correction surgeries of pediatric patiens[J]. Basic & Clinical Medicine, 2022, 42(11): 1755-1759.

0
/ / 推荐

导出引用管理器 EndNote|Reference Manager|ProCite|BibTeX|RefWorks

链接本文: http://journal11.magtechjournal.com/Jwk_jcyxylc/CN/10.16352/j.issn.1001-6325.2022.11.1755

http://journal11.magtechjournal.com/Jwk_jcyxylc/CN/Y2022/V42/I11/1755

参考文献 11

[1]	Boylan MR, Riesgo AM, Chu A, et al. Costs and complications of increased length of stay following adolescent idiopathic scoliosis surgery[J]. J Pediatr Orthop B, 2019,28:27-31.
[2]	Divecha HM, Siddique I, Breakwell LM, et al. Complications in spinal deformity surgery in the United Kingdom: 5-year results of the annual British Scoliosis Society National Audit of Morbidity and Mortality[J]. Eur Spine J, 2014,23:S55-60.
[3]	Kwan KYH, Koh HY, Blanke KM, et al. Complications following surgery for adolescent idiopathic scoliosis over a 13-year period[J]. Bone Joint J, 2020,102-B:519-523.
[4]	Cognetti D, Keeny HM, Samdani AF, et al. Neuromu-scular scoliosis complication rates from 2004 to 2015: a report from the Scoliosis Research Society Morbidity and Mortality database[J]. Neurosurg Focus, 2017,43:E10. doi: 10.3171/2017.7.FOCUS17384.
[5]	Toll BJ, Samdani AF, Janjua MB, et al. Perioperative complications and risk factors in neuromuscular scoliosis surgery[J]. J Neurosurg Pediatr,2018, 22:207-213.
[6]	Soliman HAG, Beausejour M, Joncas J, et al. Predicting lowest hemoglobin level and risk of blood transfusion in spinal fusion surgery for adolescent idiopathic scoliosis[J]. Eur Spine J, 2019, 28:1342-1348.
[7]	Yin S, Tao H, Du H, et al. Postoperative pulmonary complications following posterior spinal instrumentation and fusion for congenital scoliosis[J]. PLoS One, 2018,13:e0207657.doi: 10.1371/journal.pone.0207657.
[8]	Sharma S, Wu C, Andersen T, et al. Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years[J]. Eur Spine J, 2013, 22:1230-1249.
[9]	于芸,吴蓓,韩如泉. 系统评价保护性肺通气在俯卧位手术的应用[J]. 基础医学与临床, 2017, 37: 828-833.
[10]	Gropper MA, Cohen NH, Eriksson LI,et al. Miller's anesthesia[M]. 9th Edition. Churchill Livingstone: Elsevier, 2019:1548-1575.
[11]	Fernandez-Bustamante A, Frendl G, Sprung J, et al. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: a multicenter study by the perioperative research network investigators[J]. JAMA Surg, 2017,152:157-166.

[1]	马满姣, 马璐璐, 张秀华, 仉建国, 沈建雄, 张爱华, 陈林, 刘长城. 青少年脊柱侧弯后路矫形手术围术期异体输血的危险因素[J]. 基础医学与临床, 2022, 42(9): 1419-1423.
[2]	田晓怡, 刘颖, 姚瑶, 顾秀丽, 李爱华, 郑胡镛, 宋文琪. 儿童急性淋巴细胞白血病ABCB1、ABCC4和SLCO1B1多态性与大剂量MTX血药浓度及不良反应的相关性[J]. 基础医学与临床, 2022, 42(5): 708-713.
[3]	左宇志, 严维刚. 抗血栓药物的应用与前列腺穿刺活检术的安全性[J]. 基础医学与临床, 2022, 42(5): 824-827.
[4]	郑天圣, 佟雪巍, 张伊桐, 朱敏, 詹晓蓉. 2型糖尿病心血管并发症发病机制的研究进展[J]. 基础医学与临床, 2022, 42(5): 814-817.
[5]	王妍蕾, 董文丽, 章秋. 人工智能在糖尿病研究和临床中的应用[J]. 基础医学与临床, 2022, 42(11): 1650-1655.
[6]	钱子冰, 刘静, 曾佩芸, 张琦. mTOR调控自噬参与糖尿病并发症的研究进展[J]. 基础医学与临床, 2021, 41(8): 1200-1204.
[7]	边芳, 李宁, 李奇, 李康, 金雯. 膜联蛋白A1减轻1型糖尿病小鼠微血管并发症[J]. 基础医学与临床, 2021, 41(4): 484-489.
[8]	曹伟, 沈越, 马传荣. 预见性护理有利于稳定恶性梗阻性黄疸患者经PTCD术后情绪及降低术后并发症[J]. 基础医学与临床, 2021, 41(2): 250-253.
[9]	陈璐, 朱惠娟, 陈适, 张梅, 班博, 杨艳杰, 潘慧. 屏幕教学对儿童心理行为的影响分析[J]. 基础医学与临床, 2021, 41(12): 1868-1870.
[10]	何小义, 邹学军, 刑浩然. 目标导向液体治疗用于加速康复外科的新进展[J]. 基础医学与临床, 2020, 40(7): 995-998.
[11]	刘宁, 张伟华. 糖尿病合并高血压加重血管病变的研究进展[J]. 基础医学与临床, 2020, 40(7): 990-994.
[12]	宋秦伟, 王娅琳, 刘智圆, 张易, 高爽, 马丽娟. CMIA方法筛查儿童抗梅毒特异性抗体结果的解读[J]. 基础医学与临床, 2020, 40(10): 1381-1384.
[13]	马玉花邹亚伟彭盛卢婕伦黎波何国华刘志刚. MSCc分泌的肝细胞生长因子对人髓系白血病细胞系K562及其耐药株K562/G01增殖及药物敏感性的影响[J]. , 2019, 39(12): 1709-1716.
[14]	全婷婷聂敏王亚冰姜艳李梅夏维波王鸥邢小平. GNA11基因多态性与特发性甲状旁腺功能减退症及其并发症的关联[J]. 基础医学与临床, 2018, 38(2): 145-152.
[15]	王宝宝武元付强弓孟春石希敏景红丽李方陈朝英宋红梅秦岩李雪梅. 高效液相色谱法测定血清碘海醇浓度方法的建立和应用[J]. 基础医学与临床, 2015, 35(7): 963-967.

儿童脊柱侧弯后路矫形术后并发症的危险因素

Risk factors for postoperative complications in posterior scoliosis correction surgeries of pediatric patiens

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 11

相关文章 15

编辑推荐

Metrics

本文评价