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预测脑瘫性脊柱侧弯患儿脊柱融合术后并发症的因素。

Factors predicting postoperative complications following spinal fusions in children with cerebral palsy scoliosis.

作者信息

Nishnianidze Tristan, Bayhan Ilhan A, Abousamra Oussama, Sees Julieanne, Rogers Kenneth J, Dabney Kirk W, Miller Freeman

机构信息

Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19899, USA.

出版信息

Eur Spine J. 2016 Feb;25(2):627-34. doi: 10.1007/s00586-015-4243-0. Epub 2015 Sep 26.

Abstract

PURPOSE

The purpose of this study was to review the postoperative complications after posterior spinal fusion (PSF) in cerebral palsy (CP) scoliosis and identify the predictive preoperative risk factors.

METHODS

All PSFs consecutively performed for CP scoliosis between 2004 and 2013 were reviewed. Preoperative risk score (ORS) and postoperative complications score (POCS) were used as measures of all recorded preoperative risk factors and postoperative complications, respectively.

RESULTS

The review included 303 children with a mean age of 14.6 ± 3.0 years. Mean hospitalization was 16 days. Dependence on G-tube feeding was associated with higher POCS (P = 0.027). Postoperative fever, seizures, and septicemia were associated with higher ORS (P < 0.01). Specifically, postoperative pancreatitis and deep wound infections were more common in children with G-tube.

CONCLUSION

This study suggests that G-tube dependence is a predictive risk factor of complications after PSF in CP scoliosis. Children with G-tube need special perioperative care. No other specific preoperative risk factor predicted postoperative complications.

摘要

目的

本研究旨在回顾脑性瘫痪(CP)脊柱侧弯后路脊柱融合术(PSF)后的术后并发症,并确定术前预测风险因素。

方法

回顾了2004年至2013年间连续进行的所有CP脊柱侧弯PSF手术。术前风险评分(ORS)和术后并发症评分(POCS)分别用作所有记录的术前风险因素和术后并发症的衡量指标。

结果

该回顾纳入了303名儿童,平均年龄为14.6±3.0岁。平均住院时间为16天。依赖胃造口管喂养与较高的POCS相关(P = 0.027)。术后发热、癫痫发作和败血症与较高的ORS相关(P < 0.01)。具体而言,胃造口管儿童术后胰腺炎和深部伤口感染更为常见。

结论

本研究表明,依赖胃造口管是CP脊柱侧弯PSF术后并发症的预测风险因素。有胃造口管的儿童需要特殊的围手术期护理。没有其他特定的术前风险因素可预测术后并发症。

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