儿童脊柱侧弯后路矫形术后并发症的危险因素

Risk factors for postoperative complications in posterior scoliosis correction surgeries of pediatric patiens

目的了解儿童脊柱侧弯后路矫形术后并发症发生率及其危险因素。方法为回顾性队列研究。收集2015年1月至2017年12月期间在北京协和医院行脊柱侧弯后路矫形手术的患儿围术期资料。根据术后是否发生并发症,将患者分为并发症组和无并发症组,比较两组的临床特征。用二分类Logistic回归分析其术后发生并发症的危险因素。结果580例患者纳入研究,其术后并发症发生率为5.7%,危险因素为术前Cobb角>69.5°(OR=3.043,95%CI:1.436~6.448,P<0.01)和围术期输注异体血(OR=2.364,95%CI:1.095~5.102,P<0.05)。与无并发症组相比,并发症组患者术后返重症加强护理病房(ICU)率更高(P<0.01)和住院时间更长(P<0.001)。结论儿童脊柱侧弯后路矫形手术术后并发症发生的危险因素包括术前Cobb角>69.5°和围术期输注异体血。

Objective To investigate the postoperative complication rate in pediatric patients who underwent posterior scoliosis correction surgeries,and to identify its risk factors.Methods This study was a retrospective cohort study.Anesthetic data of pediatric patients who underwent posterior scoliosis correction surgeries from January 2015 to December 2017 in Peking Union Medical College Hospital were collected and analyzed.The clinical variables were subsequently compared between patients in whom postoperative complication occured(complication group)and those in whom did not(non-complication group).Binary Logistic regression analysis was performed to identify risk factors of postoperative complication in these patients.Results The study enrolled 580 patients.The postoperative complication rate was 5.7%and the independent risk factors leading to it included preoperative Cobb angle larger than 69.5°(OR=3.043,95%CI:1.436-6.448,P<0.01)and perioperative allogeneic transfusion(OR=2.364,95%CI:1.095-5.102,P<0.05).The postoperative transfer rate to Intensive Care Unit(ICU)(P<0.01)in complication group was higher,with longer hospital stay length(P<0.001)than that in the non-complication group.Conclusions The risk factors for postoperative complication in pediatric patients receiving posterior scoliosis correction surgeries include preoperative Cobb angle larger than 69.5°and perioperative allogeneic transfusion.