脊柱侧弯矫形手术患者术后肺部并发症的危险因素

Risk factors of postoperative pulmonary complications in patients undergoing scoliosis fusion surgery

目的分析脊柱侧弯矫形手术患者术后肺部并发症(PPCs)的危险因素。方法回顾性分析2013年8月至2020年10月择期行后入路脊柱侧弯矫形手术的463例患者病历资料。根据患者术后是否发生PPCs分为两组:PPCs组和非PPCs组。采用倾向性评分匹配和多因素Logistic回归分析脊柱侧弯矫形手术患者发生PPCs的相关危险因素。结果有154例(33.3%)患者发生PPCs。将性别、年龄、ASA分级、吸烟史、高血压病史、Cobb角作为匹配因子进行倾向性评分匹配,再进行多因素Logistic回归分析,结果显示术中输注异体红细胞(OR=1.983,95%CI 1.135~3.465,P=0.016)和手术时间延长(OR=1.426,95%CI 1.112~1.831,P=0.005)是发生PPCs的独立危险因素。结论手术时间延长、术中输注异体红细胞是脊柱侧弯矫形手术术后肺部并发症发生的危险因素。

Objective To explore the risk factors of postoperative pulmonary complications(PPCs)in patients with scoliosis fusion surgery.Methods A total of 463 patients undergoing posterior instrumentation and fusion surgery from August 2013 to October 2020 were included in this retrospective study.Patients were divided into two groups according to whether PPCs occurred after operation:PPCs group and non PPCs group.Propensity score matching and multivariate logistic regression were used to analyze the risk factors of PPCs in patients with scoliosis fusion surgery.Results A total of 154 patients(33.3%)developed PPCs.Propensity score matching was performed based on preoperative factors such as sex,age,ASA physical status,smoking history,hypertension,and Cobb angle.Multivariate logistic regression analysis showed that intraoperative infusion of allogeneic red blood cells(OR=1.983,95%CI 1.135-3.465,P=0.016)and the operation time prolonged(OR=1.426,95%CI 1.112-1.831,P=0.005)were the independent factors of PPCs.Conclusion The operation time prolonged and intraoperative infusion of allogeneic red blood cells are related risk factors for postoperative pulmonary complications.