腰椎椎体间融合术患者术中压力性损伤风险分析

Risk analysis of intraoperatively acquired pressure injuries in patients with lumbar interbody fusion

目的评估腰椎椎体间融合术(LIF)患者发生术中压力性损伤(IAPI)的相关危险因素,为临床实践中制定术后预防措施和治疗IAPI的应对措施提供依据。方法选择2021年1月至2024年1月在合肥市第二人民医院住院治疗的205例LIF手术患者的临床资料进行回顾性分析。根据是否发生IAPI,将患者分为IAPI组和非IAPI组。收集基本资料及围手术期主要临床数据和指标,进行单变量和逻辑回归分析,以确定LIF手术患者发生IAPI的危险因素。结果术后48 h,本组研究对象IAPI发生率为38.05%。单因素分析显示,手术时间、低蛋白血症、灌注和糖尿病与IAPI的发生显著相关(均P<0.05)。Logistic回归分析结果显示,手术时间(OR=1.032)、糖尿病(OR=2.661)、低蛋白血症(OR=2.786)和灌注(OR=3.254)是IAPI的独立危险因素。结论手术时间、低蛋白血症、灌注和糖尿病与接受LIF患者发生IAPI密切相关。

Objective To evaluate the risk factors of Intraoperatively acquired pressure injuries(IAPI)in patients with lumbar interbody fusion(LIF),and to provide a basis for the prevention and treatment of IAPI in clinical practice.Methods Clinical data of 205 patients receiving LIF who were hospitalized in Hefei Second People's Hospital from January 2021 to January 2024 were selected for retrospective analysis.They were divided into IAPI group and non-IAPI group according to whether IAPI occurs.Results At 48 h postoperatively,the incidence of IAPI in our study group was 38.05%.Univariate analysis showed that operative time,hypoproteinemia,perfusion and diabetes were significantly associated with the development of IAPI(all P<0.05).Logistic regression analysis showed that operative time(OR=1.032),diabetes mellitus(OR=2.661),hypoproteinemia(OR=2.786),and perfusion(OR=3.254)were independent IAPI risk factors for IAPI.Conclusion Operative time,hypoproteinemia,perfusion,and diabetes mellitus are strongly associated with the development of IAPI in patients undergoing LIF,warranting the implementation of clinically focused perioperative management to prevent and manage IAPI.