退行性腰椎滑脱术后并发脑脊液漏的相关因素Logistic回归分析

摘要

Objective To investigate the related factors of cerebrospinal fluid leakage after surgical treatment of degenerative spondylolisthesis (DS).Methods From September 2010 to September 2016,the clinical data of 198 patients with DS treated in our hospital were analyzed retrospectively.The cerebrospinal fluid leakage was used as independent variable.Gender,age,hypertension and diabetes,past smoking and alcohol abuse,slippage classification,surgical procedures and operation time were used as dependent variables.Univariate analysis was performed on the data of the independent variables and dependent variables,and the Logistic regression analysis was used to deal with the statistical differences among the univariate analysis.Results Of 198 cases,19 cases occurred cerebrospinal fluid leakage (9.6％),all recovered after symptomatic treatment.Univariate analysis showed that the average age,spondylolisthesis Meyerding indexing and operation method had statistical significance (P＜0.05).Multivariate Logistic regression analysis showed that the Meyerding index (OR=3.947,P=0.015),high elderly patients (OR=2.975,P=0.036),PLIF operation (OR=4.614,P=0.023) were the independent risk factors for postoperative cerebrospinal fluid leakage in DS patients.Conclusion The risk factors of cerebrospinal fluid leakage in patients with DS are the elderly,the severity of spondylolisthesis,and the operation of PLIF.%目的 探讨退行性腰椎滑脱(degenerative spondylolisthesis,DS)手术后发生脑脊液漏的相关因素.方法 回顾性分析了2010-09-2016-09手术治疗的198例DS患者临床资料,将术后是否发生脑脊液漏作为自变量,将性别、年龄、合并高血压和糖尿病、既往吸烟和酗酒史,以及滑脱分级、手术方式、手术时间等数据,作为因变量.对上述自变量和因变量的数据进行单因素分析;单因素分析存在统计学差异者,则进一步以Logistci回归分析进行处理.结果 198例术后共发生19例脑脊液漏(9.6％),均予以对症处理后痊愈.单因素分析显示,平均年龄、滑脱椎体的Meyerding分度、手术方法等三项因素存在统计学意义(P＜0.05);多因素Logistic回归分析提示,Meyerding分度高(OR =3.947,P=0.015)、高龄患者(OR =2.975,P=0.036)、PLIF手术(OR=4.614,P=0.023),均为导致DS患者术后并发脑脊液漏的独立危险因素之一.结论 高龄、椎体滑脱程度严重、行PLIF手术治疗,均为DS患者术后发生脑脊液漏的危险因素.