腰椎退行性疾病行减压/融合术后早期并发症的风险因素分析

Risk factors of early complications after decompression/fusion for lumbar degenerative diseases

目的 探讨腰椎退行性疾病行减压/融合术后30d内并发症的发生情况及预测因素。方法 选择2011年1月~2018年12月在本院行减压/融合手术治疗的271例腰椎退行性疾病患者,记录术后30d内并发症发生率,统计其临床特征与30d内并发症发生情况的相关性。结果 271例中,41例患者术后30d发生并发症44例次,30d内并发症发生率为15.13%。单因素分析显示,体质量指数、吸烟史、饮酒、高血压、慢性肺部疾病、手术方式、手术医师等因素无统计学意义(P>0.05),性别、年龄、ASA分级、糖尿病、滑脱分度、手术节段和手术时间等因素存在统计学意义(P<0.05)。二分类多因素Logistic分析结果显示,ASA分级Ⅲ~Ⅳ级、手术时间≥2h是影响30d内并发症发生率的独立影响因素(P<0.05)。结论 ASA分级增加和手术时间延长均是椎管狭窄合并腰椎滑脱行减压/融合术后30d内并发症发生的预测因素。

Objective To investigate the occurrence and predictive factors of complications within 30 days after decompression and fixation of lumbar degenerative diseases. Methods From January 2011 to December 2018, 271 patients with spinal stenosis with lumbar spondylolisthesis who underwent surgical treatment in our hospital were selected in the study. The patients' medical records were reviewed to record the clinical characteristics and complications within 30 days. The correlation between clinical characteristics and complications within 30 days was analyzed. Results A total of 41 patients had 44 complications within 30 days after operation, and the incidence rate of complications within 30 days was 15.13%. Univariate analysis showed that there were no significant differences in body mass index, smoking history, alcohol consumption, hypertension, chronic pulmonary diseases, surgical Methods , surgeons and other factors ( P >0.05).There were significant differences in sex, age, ASA classification, diabetes mellitus, spondylolisthesis, operative segment and operative time between patients with and without complications within 30 days ( P <0.05).The Results of logistic analysis showed that ASA grade III-IV and operation time > 2 h were independent factors influencing the incidence of complications within 30 days ( P <0.05). Conclusion Increased ASA classification and prolonged operation time are predictors of complications within 30 days after spinal stenosis with lumbar spondylolisthesis.