外科治疗胸腰椎体畸形患者发生严重并发症的影响因素

摘要

目的 探究外科治疗胸腰椎体畸形患者发生严重并发症的影响因素.方法 回顾性分析2011年6月至2016年6月该院收治的164例胸腰椎体畸形患者的临床资料,所有患者均经胸腰椎体畸形矫正手术治疗,依据患者术后是否发生严重并发症将164例患者分为严重并发症组(n=18)和非严重并发症组(n= 146).分析外科治疗胸腰椎体畸形患者发生严重并发症的危险因素.结果 18例严重并发症患者中发生率较高的严重并发症为神经损伤、胸膜损伤和不愈合.Logistic多因素分析结果显示,病史长、术前存在神经损伤、最大肺活量低、手术时间长、术中出血量多、术中截骨为外科治疗胸腰椎体畸形患者发生严重并发症的危险因素(P<0.05).结论 临床上应加强对病史长、术前存在神经损伤、最大肺活量低、手术时间长、术中出血量多、术中截骨的胸腰椎体畸形患者的监测,以降低术后严重并发症的发生率.%Objective To explore the influence factors of severe complications in the surgical treatment for the patients with thoracolumbar vertebral deformities. Methods The clinical data in 164 cases of thoracolumbar vertebral deformity in this hospital from June 2011 to June 2016 were retrospectively analyzed. All cases were treated by thoracic and lumbar deformity correction surgery and divided into the severe complication group (n= 18) and non-complication group (n= 146) according to postoperative complications. The risk factors of severe complications occurrence in surgical treatment of thoracolumbar vertebral deformities were analyzed. Results Among 18 cases of severe complications,the severe complications with higher occurrence rates were the nerve injury,pleural injury and non-union. The multivariate Logistic analysis results showed that the long disease history, preoperative neurological damage,low FVC, long operation time, more amount of intraoperative bleeding and intraoperative osteotomy were the risk factors of severe complications occurrence in surgical treatment of thoracolumbar vertebral deformities (P < 0. 05 ). Conclusion Clinic should strengthen the monitoring on the patients with long disease history, preoperative neurological damage, low FVC,long operation time, more amount of intraoperative bleeding and intraoperative osteotomy in order to reduce the occurrence rate of postoperative severe complications.