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预测颈椎前路椎体次全切除融合术后患者手术引流量增加的危险因素。

Risk factors for predicting increased surgical drain output in patients after anterior cervical corpectomy and fusion.

作者信息

Liang Jinqian, Hu Jianhua, Chen Chong, Yin Hao, Dong Fangliang

机构信息

Department of Orthorpaedic Surgery, Peking Union Medical College Hospital, No.1 Shuaifuyuan, Dongcheng district, Beijing, 100730, People's Republic of China.

Department of Spine Union, Hunan Provincial People's Hospital, No.61 Jiefangxi Road, Changsha, Hunan, 410005, People's Republic of China.

出版信息

J Orthop Surg Res. 2017 Dec 28;12(1):196. doi: 10.1186/s13018-017-0698-5.

Abstract

BACKGROUND

Although measures to reduce and treat the postoperative surgical drain output are discussed, along with the increased interest in causative factors related to the prevention and treatment reported by many studies, these are still controversial.

METHODS

A retrospective study was conducted on a consecutive series of 217 patients who had underwent ACCF between January 2016 and March 2017. Patients were categorized based on normal or increased total drain output. These two groups were compared for demographic distribution and clinical data to investigate the predictive factors of increased drain output by multivariate analysis.

RESULTS

The overall incidence rate of increased drain output after ACCF was 16.6%. There are no significant differences in sex, BMI, history of taking aspirin, and ASA classification between the two groups (P > 0.05). Of the patients with increased drain output, a significantly higher proportion of patients have OPLL in the surgical level, 18 (50.0%) versus 33 (18.2%) (P = 0.000). The mean age was 60.67 ± 8.18 years versus 54.41 ± 10.05 years (P = 0.001). Number of discs involved was 2.42 ± 0.50 versus 2.02 ± 0.65 (P = 0.001). Operation time was 112.22 ± 16.49 min versus 105.21 ± 17.89 min (P = 0.031). Intraoperative blood loss was 109.86 ± 62.02 mL versus 87.83 ± 56.40 mL (P = 0.036). Logistic regression analysis showed that age (OR, 1.075; p = 0.003), history of smoking (OR, 2.792; p = 0.021), OPLL in surgical level (OR, 2.107; p = 0.001), and number of discs involved (OR, 2.764; p = 0.003) maintained its significance in predicting likelihood of increased surgical drain output.

CONCLUSIONS

The occurrence of increased drain output after ACCF is most likely multifactorial and is related to age, history of smoking, OPLL in surgical level, and number of discs involved.

摘要

背景

尽管讨论了减少和治疗术后手术引流液量的措施,并且许多研究报告了对与预防和治疗相关的致病因素的兴趣增加,但这些仍存在争议。

方法

对2016年1月至2017年3月期间连续接受ACCF手术的217例患者进行回顾性研究。根据总引流液量正常或增加对患者进行分类。比较这两组的人口统计学分布和临床数据,以通过多变量分析研究引流液量增加的预测因素。

结果

ACCF术后引流液量增加的总体发生率为16.6%。两组在性别、BMI、服用阿司匹林史和ASA分级方面无显著差异(P>0.05)。在引流液量增加的患者中,手术节段存在OPLL的患者比例显著更高,分别为18例(50.0%)和33例(18.2%)(P=0.000)。平均年龄分别为60.67±8.18岁和54.41±10.05岁(P=0.001)。受累椎间盘数量分别为2.42±0.50个和2.02±0.65个(P=0.001)。手术时间分别为112.22±16.49分钟和105.21±17.89分钟(P=0.031)。术中失血量分别为109.86±62.02毫升和87.83±56.40毫升(P=0.036)。逻辑回归分析显示,年龄(OR,1.075;p=0.003)、吸烟史(OR,2.792;p=0.021)、手术节段的OPLL(OR,2.107;p=0.001)和受累椎间盘数量(OR,2.764;p=0.003)在预测手术引流液量增加的可能性方面仍具有显著性。

结论

ACCF术后引流液量增加的发生很可能是多因素的,并且与年龄、吸烟史、手术节段的OPLL和受累椎间盘数量有关。

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