青少年特发性脊柱侧凸后路矫形术中出血量的相关影响因素分析

Analysis of the influencing factors of blood loss in posterior correction of adolescent idiopathic scoliosis

目的探讨青少年特发性脊柱侧凸后路矫形术中出血量的相关影响因素。方法 2010-01-2012-12对240例接受单纯后路矫形内固定的青少年特发性脊柱侧凸患者的临床资料进行回顾性分析,以性别、Lenke分型、融合节段数、置钉数、主弯cobb角、手术时间、Risser征、身高及体重作为变量,通过逐步回归筛选法分析探讨影响术中出血量的因素。结果融合节段数为5-15个,平均(9.7±3.5)个;置钉数为10-20个,平均(14.5±2.1)个。出血量为400-2300 ml,平均(945±259)ml;手术时间为150-260 min,平均(183±18)min。多元线性回归分析示:融合节段数,手术时间,置钉数对术中出血量有显著影响(P<0.01)。性别、Lenke分型、主弯cobb角、Risser征、身高及体重对术中出血量影响无统计学意义(P>0.05)。结论手术时间、融合节段数和置钉数是术中出血量的显著影响因素。

Objective To investigate the influencing factors of blood loss in posterior correction surgery for adolescent idiopathic scoliosis （AIS） with pedicle screws system. Methods The clinical data of 240 AIS patients who underwent posterior correction operation from January 2010 to De-cember 2012 were retrospectively reviewed. The patients＇ demographics,Lenke classification,number of fused vertebrae,number of implant,Cobb angle of chief scoliosis,operative time and Risser sign were collected and employed as independent variances. Multiple regression analysis and stepwise regression was performed to ascertain the influencing factors of blood loss. Results The average number of fused vertebrae was 9.7 segments （ranged from 5 to 15 segments）,average number of implant was 14.5 screws （ranged from 10 to 20）. The average estimated blood loss was 945 ml （ranged from 400 to 2300 ml）. The average operative time was 183 minutes （ranged from 150 to 260 minutes）. Multiple regression analysis showed that the operative time,number of fused verte-brae and number of implant were significant determinants of the blood loss （P0.05）. Conclusion Operative time,number of fused vertebrae and number of implant are the significant influencing factors of blood loss.