手术治疗脊柱转移瘤患者预后影响因素的Logistic及Cox回归模型分析

Analysis of the factors impact on the prognosis of patients with spinal metastases treated by Logistic and Cox regression model

目的:分析影响接受手术治疗的脊柱转移瘤患者预后的相关因素,为手术治疗脊柱转移瘤提供参考依据。方法:将48例接受手术治疗的脊柱转移瘤患者住院资料及随访结果进行整理。患者的性别、年龄、病椎部位、病椎数目、肿瘤性质、基础疾病、神经受损、基本状况、手术方式、术后并发症、手术时间、内脏转移、术中出血、术中输血与患者生存状态及生存时间分别作Logistic及Cox回归分析。结果:回归模型分别显示病椎数目、肿瘤性质、手术方式、内脏转移对患者预后影响有统计学意义(P<0.05)。而性别、年龄、病椎部位、基础疾病、神经受损、基本状况、术中出血、术中输血对患者预后无统计学意义(P>0.05)。结论:脊柱转移瘤患者病椎的数量、肿瘤自身的恶性程度以及有无内脏转移,为影响患者预后的危险因素;手术方式为患者预后的保护因素。而神经受损和患者术前基本情况对患者预后影响较小。对具有手术指征的脊柱转移瘤患者,应积极考虑手术治疗。

Objective：To analyze the prognostic factors of patients with spinal metastases who received surgical treatment,and to provide proposal for surgical treatment of spinal metastases.Methods：Forty-eight patients with spinal metastases were followed up to this study.The observed factors including patient＇s gender,age,site of involved vertebra,number of pathological vertebra,tumor characters,basic disease,nerve involved,general condition,surgery methods,postoperative complications,surgery time,visceral metastases,intraoperative blood and transfusion were obtained to Logistic and Cox regression analysis about these factors impacting on the prognosis of patients.Results：The factors including number of pathological vertebra,tumor characters,surgery methods and visceral metastases impact on the prognosis of patient in statistical significant.Otherwise,the factors including gender,site of involved vertebra,basic disease,nerve involved,general condition,intraoperative blood and transfusion did not impact on the prognosis of patient in statistical significant.Conclusion：The target including number of pathological vertebra,tumor characters,surgery methods and visceral metastases are risk factor in patient prognosis.But nerve involved and general conditions have less impact on patient prognosis.For patients with spinal metastases should be considered surgery if have surgical indication.