经皮椎体后凸成形术患者发生围手术期高血压危象的危险因素分析:217例回顾性研究

Risk factor analysis for perioperative hypertensive crisis in percutaneous kyphoplasty:a retrospective study of 217 patients

目的:探讨接受经皮椎体后凸成形术(PKP)患者围手术期高血压危象(PHC)的发生率和危险因素。方法:回顾性纳入2019年1月至2022年5月因骨质疏松性椎体压缩骨折而接受单节段PKP的217例患者。采用病案系统查询和电话随访的方法收集患者的人口学参数、临床特点参数及手术治疗参数。按照患者是否发生PHC进行分组,统计PKP发生PHC的发生率并分析其相关的危险因素。结果:PKP发生PHC的发生率为41.9%(91/217)。单变量和多变量危险因素分析结果显示,高龄(OR=1.841,95%CI:1.052~3.224,P=0.033)和女性(OR=2.229,95%CI:1.143~4.347,P=0.019)为PKP发生PHC的独立危险因素。此外,PKP术中应用非甾体抗炎药的患者发生PHC的风险明显降低(OR=0.353,95%CI:0.136~0.914,P=0.032)。PHC发生与术前是否合并高血压无明显相关性。结论:PHC在PKP术中发生率较高,其发生与术前合并高血压无明显相关性。女性和高龄是接受PKP的患者发生PHC的独立危险因素。术中应用非甾体抗炎药可降低PHC的发生风险。

Objective: To investigate the incidence and risk factors of perioperative hypertensive crisis(PHC) in patients undergoing percutaneous kyphoplasty. Methods: We retrospectively analyzed 217 patients who received percutaneous kyphoplasty from January2019 to May 2022. The following data were collected: demographic information, clinical characteristics, and treatment parameters. The incidence of PHC was calculated, and the risk factor for PHC analysis was determined by univariate and multivariate analyses. Results:The incidence of PHC of percutaneous kyphoplasty was 41.9%. The risk factor analyses demonstrated that ageing(OR=1.841, 95%CI:1.052-3.224, P=0.033) and females(OR=2.229, 95%CI: 1.143-4.347, P=0.019) were independent risk factors for PHC. The use of nonsteroidal anti-inflammatory drug(NSAID) during surgery significantly reduced the incidence of PHC(OR=0.353, 95%CI: 0.136-0.914, P=0.032). Moreover, PHC was not correlated with baseline accompanying hypertension. Conclusions: PHC is an underestimated situation for percutaneous kyphoplasty, which is not correlated with hypertension at baseline. Ageing and females are independent risk factors for PHC. The application of NSAIDs during surgery may reduce the risk of PHC.