Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.
Spine (Phila Pa 1976). 2018 May 1;43(9):630-636. doi: 10.1097/BRS.0000000000002389.
A prospective study.
To investigate the incidence and risk factors of acute pancreatitis after scoliosis surgery.
Pancreatitis has been recognized as a possible complication of extra-abdominal surgeries. However, there were few reports on the incidence and risk factors of acute pancreatitis after scoliosis surgery.
A prospective clinical study was performed at our center from September 2014 to October 2015. One hundred seventy-six patients undergoing posterior spinal correction surgery were enrolled. The diagnosis of acute pancreatitis was based on their clinical manifestations combined with laboratory examination. Demographic, intraoperative, and radiological parameters were evaluated to identify the risk factors of acute pancreatitis after scoliosis surgery.
Thirteen patients (7.4%) were diagnosed with acute pancreatitis. Compared with patients without pancreatitis, pancreatitis patients had lower body mass index (BMI) (15.5 vs. 19.5, P = 0.001), larger preoperative Cobb angle of major curve (87.5° vs. 59.2°, P < 0.001), lower correction rate (57.4% vs. 69.0%, P = 0.045), lower intraoperative mean arterial pressure (57.9 mmHg vs. 66.1 mmHg, P < 0.001), and longer fusion levels (13.3 vs. 10.1, P < 0.001). No significant differences were noted with respect to operation time, intraoperative blood loss, or the amount of sagittal profile correction. Furthermore, multivariate logistic analysis revealed that BMI (odds ratio [OR] = 1.542, P = 0.009), lowest intraoperative mean arterial pressure (OR = 1.126, P = 0.039), and segments of fusion (OR = 0.551, P = 0.025) were independent risk factors for postoperative acute pancreatitis. All cases were treated with bowel rest, intravenous fluids, and fasting and completely recovered with 3.3 (2-5) days.
The incidence of postoperative acute pancreatitis after scoliosis surgery was 7.4%. The low BMI, lowest intraoperative mean arterial pressure, and long segments of fusion were independent risk factors for acute pancreatitis after scoliosis surgery.
前瞻性研究。
探讨脊柱侧凸手术后胰腺炎的发生率和危险因素。
胰腺炎已被认为是腹部外手术的一种可能并发症。然而，关于脊柱侧凸手术后胰腺炎的发生率和危险因素的报道甚少。
本研究为 2014 年 9 月至 2015 年 10 月在我院进行的一项前瞻性临床研究。纳入 176 例接受后路脊柱矫正手术的患者。胰腺炎的诊断基于其临床表现结合实验室检查。评估了人口统计学、术中及影像学参数，以确定脊柱侧凸手术后胰腺炎的危险因素。
13 例（7.4%）患者诊断为急性胰腺炎。与无胰腺炎患者相比，胰腺炎患者的体重指数（BMI）较低（15.5 比 19.5，P=0.001），术前主弯 Cobb 角较大（87.5°比 59.2°，P<0.001），矫正率较低（57.4%比 69.0%，P=0.045），术中平均动脉压较低（57.9mmHg 比 66.1mmHg，P<0.001），融合节段较长（13.3 比 10.1，P<0.001）。手术时间、术中出血量或矢状面矫正量无显著差异。此外，多变量逻辑分析显示，BMI（比值比[OR]＝1.542，P=0.009）、术中最低平均动脉压（OR＝1.126，P=0.039）和融合节段数（OR＝0.551，P=0.025）是术后急性胰腺炎的独立危险因素。所有患者均接受了肠道休息、静脉补液和禁食治疗，3.3（2-5）天内完全康复。
脊柱侧凸手术后胰腺炎的发生率为 7.4%。BMI 低、术中平均动脉压低和融合节段长是脊柱侧凸手术后胰腺炎的独立危险因素。
3 级。
