腰椎融合术后发热特点趋势及预后分析

Analysis of Characteristics and Prognosis of Postoperative Pyrexia in Lumbar Fusion

目的观察分析腰椎融合术后发热的特点与趋势,及其与预后的相关性。方法回顾性分析2017年9月至2018年9月在广州市番禺区中医院骨三科接受腰椎融合术的126例患者的病历资料,其中男38例,女88例,年龄(57.64±11.16)岁,详细记录每例患者术前1d至术后7d内每天的最高体温、住院期间是否发生感染事件、感染事件类型及术后住院天数等。将术后发热定义为≥37.8℃。观察所有患者的术后体温变化趋势和发热特点,分析连续发热与术后感染事件发生的相关性,以及对术后住院天数的影响。结果共35例患者(27.78%)出现术后发热表现;首次发热常见于术后第1天(62.86%);每天平均最高体温见于术后第1天,为(37.30±0.50)℃;术后发热率最高见于术后第1天(17.46%);引起术后发热的原因中,非感染性因素共28例(80%)。连续发热≥2d与术后感染事件发生具有明显相关性(χ2=7.359,P<0.01),且显著延长术后住院天数(t=3.300,P<0.01)。结论引起腰椎融合术后发热的原因中,以非感染性因素较常见。持续至少2d的发热,感染事件发生率明显增高,且术后住院天数延长。

Objective To observe and analyze the characteristics of postoperative pyrexia and the correlation with prognosis after lumbar fusion.Methods A retrospective study was conducted in the 126 patients who underwent lumbar fusion from September 2017 to September 2018 in the Department of Orthopaedics,Panyu Hospital of Chinese Medicine,including 38 males and 88 females,aged(57.64±11.16)years old.The daily highest temperature(from pre-operation day 1 to postoperation day 7),infections during the hospitalization,the type of infections,and the length of stay were collected.The postoperative pyrexia was defined as over 37.8 ℃.The changes of postoperative temperature,and characteristics of postoperative pyrexia were observed.The correlation between continuous fever(over 2 days)and infection events was analyzed,as well as the effect on the length of stay.Results A total of 35 patients(27.78%)experienced postoperative fever.The first pyrexia commonly occured on day 1 postoperatively(62.86%).The average highest temperature was found on day 1 postoperatively(37.30±0.50)℃.Among all patients,the highest fever rate occured on day 1 postoperatively(17.46%).Non-infectious factors caused pyrexia in 28 cases(80%).Continuous fever was significantly associated with postoperative infection(χ^2=7.359,P<0.01),and significantly prolonged the length of stay(t=3.300,P<0.01).Conclusion Non-infectious factor is the most common reason for postoperative pyrexia after lumbar fusion.Consecutive pyrexia for at least 2 days may increase the incidence of infection,and prolong the length of stay.