胸腰椎骨折手术患者术中压力性损伤发生的影响因素

Influencing factors of intraoperative pressure injury in patients with thoracolumbar fracture

目的探讨胸腰椎骨折手术患者术中发生压力性损伤(PI)的影响因素。方法选择2022年1月至7月上海交通大学附属新华医院150例行俯卧位胸腰椎骨折手术患者临床资料进行回顾性分析,根据术中是否发生PI分为发生组(24例)和未发生组(126例)。对两组一般信息资料与临床资料做单因素统计分析,初步筛选出可能影响胸腰椎骨折手术患者术中PI的指标;采用logistic回归分析胸腰椎骨折手术患者术中PI的独立危险因素。结果头面部发生术中PI的占比最高。两组术前血清白蛋白(Alb)水平、手术时间、术中使用的保护性材料、使用血管活性药物情况比较,差异有统计学意义(P<0.05);logistic回归分析显示,术前血清Alb低表达、手术时间较长、术中使用的保护性材料、血管活性药物是胸腰椎骨折手术患者术中发生PI的影响因素(P<0.05)。结论术前血清Alb表达、手术时间、术中使用的保护性材料、血管活性药物可影响胸腰椎骨折手术患者发生术中PI。

Objective To investigate the influencing factors of intraoperative pressure injuries(PI)in patients with thoracolumbar fracture.Methods The clinical data of 150 patients undergoing prone thoracolumbra fracture surgery in the Shanghai Jiao Tong University Medical College Affiliated Xinhua Hospital from January to July 2022 were retrospectively analyzed.According to whether PI occurred during the operation,the patients were divided into the occurrence group(24 cases)and the non-occurrence group(126 cases).Univariate statistical analysis was performed on the general information and clinical data of the two groups,and the indexes that may affect the intraoperative PI of the patients undergoing thoracolumbar fracture surgery were initially screened.The independent risk factors of PI in patients undergoing thoracolumbar fracture surgery were analyzed by logistic regression.Results The ratio of PI injury in head and face surgery was the highest.Preoperative serum albumin(Alb)level,operation time,protective materials used during operation,and vasoactive drugs were compared between the two groups,the differences were statistically significant(P<0.05).Logistic regression analysis showed that low serum Alb expression before surgery,long operation time,protective materials used during surgery,and vasoactive drugs were the influencing factors for intraoperative PI in patients with thoracolumbar fracture surgery(P<0.05).Conclusion The low expression of serum Alb before surgery,long operation time,protective materials used during operation,and vasoactive drugs may affect the occurrence of PI in patients undergoing thoracolumbar fracture surgery.