儿童脊柱侧弯术后白细胞计数升高的影响因素分析

Analysis of influencing factors for white blood cell count elevation after scoliosis surgery in children

目的 探讨儿童脊柱侧弯术后白细胞计数(WBC)升高的影响因素。方法 分析首都医科大学附属北京朝阳医院2017年1月至2021年7月因脊柱侧弯行手术治疗的81例患儿的临床资料,根据术后WBC是否超过正常值范围分为正常组(29例)和升高组(52例)。比较两组一般资料及实验室检查结果,采用单因素分析筛选潜在风险变量(P<0.2),采用多因素logistic回归模型分析术后WBC升高的危险因素。结果 两组年龄、性别、体重指数、主胸弯Cobb’s角、术前血红蛋白水平、生活地区、尿量、出血量、术后C反应蛋白水平、术后血红蛋白水平、术后住院时间比较,差异无统计学意义(P>0.05)。两组手术时间、术中补液量、分组补液量、术后血小板计数比较,差异有统计学意义(P<0.05)。Cobb’s角、手术时间、分组补液量、术后血小板计数是术后WBC升高的影响因素(OR=0.973、1.012、0.129、1.023,P<0.05)。结论 儿童脊柱侧弯术后WBC升高可能与主胸弯Cobb’s角过大、手术时间过长、分组补液量≤20 ml/(kg·h)及术后血小板计数升高密切相关。

Objective To investigate the influencing factors for white blood cell count(WBC)elevation after scoliosis surgery in children.Methods Clinical data of 81 children patients who underwent surgical treatment for scoliosis in Beijing Chao-Yang Hospital,Capital Medical University from January 2017 to July 2021 were collected,and according to whether WBC exceeded range of normal value,they were divided into normal group(29 cases)and elevated group(52 cases).General data and laboratory results were compared between two groups,single factor analysis was used to screen potential risk variables(P<0.2),and multivariate logistic regression model was used to analyze the influencing factors of postoperative WBC elevation.Results There were no significant differences in age,sex,body mass index,Cobb’s angle of major thoracic curvature,preoperative hemoglobin level,living area,urine volume,blood loss,postoperative C-reactive protein level,postoperative hemoglobin level,and postoperative hospital stay between two groups(P>0.05).There were statistically significant differences in operation duration,intraoperative fluid volume,subgroup fluid volume,and postoperative blood platelet count between two groups(P<0.05).Cobb’s angle of major thoracic curvature,operation duration,subgroup fluid volume,and postoperative blood platelet count were influencing factors for postoperative WBC elevation(OR=0.973,1.012,0.129,1.023,P<0.05).Conclusion WBC elevation after scoliosis surgery in children may be closely related to the large Cobb’s angle of major thoracic curvature,the prolonged operation time,subgroup fluid volume≤20 ml/(kg·h),and the increase of postoperative platelet count.