术前类固醇应用史对选择性前路腰椎融合术围手术期并发症的影响

Influence of steroid history on perioperative complications of selective anterior lumbar interbody fusion

目的探讨术前类固醇应用史对选择性前路腰椎融合术(anterior lumbar fusion,ALF)围手术期并发症的影响。方法选择2015年1月~2020年1月在本院行ALF、术前类固醇应用史的112例患者资料作为研究组,抽取同期在本院行ALF、无术前类固醇应用史的患者112例作为对照组。对两组患者的围手术期并发症发生情况进行比较;以是否发生围手术期并发症为应变量,采用多因素分析以验证术前类固醇应用史对围手术期并发症发生率的影响。结果研究组围手术期总并发症发生率高于对照组,差异有统计学意义(P<0.05)。多因素分析显示,术前类固醇应用史是围手术期并发症的风险因素(P<0.05),其他风险因素包括:年龄≥60岁、ASA分级Ⅲ~Ⅳ级、≥3个节段融合、翻修手术(P<0.05)。结论术前类固醇应用史与ALF手术患者围手术期并发症增加相关。

Objective To investigate the influence of preoperative steroid history on perioperative complications of selective anterior lumbar interbody fusion(ALF).Methods From January 2015 to January 2020, 112 patients with steroid history before ALF surgery in our hospital were selected as the research group, and 112 patients of no steroid history before ALF surgery in our hospital were selected as the control group. The perioperative complications of the two groups were compared. With the occurrence of perioperative complications as the dependent variable, the influence of steroid history on the incidence of perioperative complications was analyzed by univariate or multivariate analysis.Results The incidence rate of perioperative complications in the study group was higher than that in the control group(P<0. 05). Multivariate analysis showed that steroid history was a risk factor for perioperative complications(P<0.05). Other risk factors included age ≥ 60 years old, ASA grade Ⅲ ~ Ⅳ, ≥ 3 segment fusion and revision surgery(P<0. 05).Conclusion Preoperative steroid history is associated with increased perioperative complications in patients undergoing ALF surgery.