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压力性溃疡手术后的并发症 - 对 118 例脊髓损伤患者手术的研究。

Complications after pressure ulcer surgery - a study of 118 operations in spinal cord injured patients.

机构信息

Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Plast Surg Hand Surg. 2020 Jun;54(3):145-150. doi: 10.1080/2000656X.2020.1720700. Epub 2020 Jan 31.

Abstract

Our aim in this study was to examine which factors are associated with post-operative complications after surgery for pressure ulcers in individuals with spinal cord injury. We performed a retrospective cohort study including all spinal cord injured patients undergoing pressure ulcer surgery in our department between 2002 and 2019. Patient demographics and comorbidity were collected from medical records, as were treatment data and information on post-operative complications within 30 days. Assessment of outcomes was performed through -tests, -tests and ANOVA. Out of 118 operations, 51 (43%) had a post-operative complication of any kind. The vast majority (44 cases, 86% of all complications) had minor complications (Clavien-Dindo grade I or II). Seven patients (6%) had a complication of Clavien-Dindo grade III or higher, requiring return to theatre or ICU care. We found that a higher age, a low serum albumin (<3.5 g/dl), and over or underweight, were associated with an increased risk of complications ( < 0.05). Out of 143 treated ulcers, 132 were evaluated at a follow-up visit one to two months after surgery, and 99 of these (75%) were healed. Surgery of pressure ulcers in patients with spinal cord injury is not a low-risk venture, however, few patients will suffer serious post-operative complications. A majority of treated ulcers will heal shortly post-operatively. A number of risk factors are associated with post-operative complications, which can be of help to guide patient selection in the future.

摘要

本研究旨在探讨哪些因素与脊髓损伤患者压疮手术后的术后并发症相关。我们进行了一项回顾性队列研究,纳入了 2002 年至 2019 年期间在我科行压疮手术的所有脊髓损伤患者。从病历中收集了患者的人口统计学和合并症数据,以及治疗数据和术后 30 天内并发症的信息。通过 -检验、-检验和 ANOVA 对结果进行评估。在 118 例手术中,有 51 例(43%)发生了任何类型的术后并发症。绝大多数(44 例,所有并发症的 86%)为轻度并发症(Clavien-Dindo 分级 I 或 II)。7 例(6%)患者出现 Clavien-Dindo 分级 III 或更高的并发症,需要返回手术室或 ICU 治疗。我们发现,年龄较大、血清白蛋白较低(<3.5g/dl)、超重或体重不足与并发症风险增加相关(<0.05)。在 143 例治疗的溃疡中,有 132 例在术后 1 至 2 个月的随访中进行了评估,其中 99 例(75%)已愈合。脊髓损伤患者的压疮手术并非低风险手术,但少数患者会遭受严重的术后并发症。大多数治疗后的溃疡在术后短期内会愈合。许多危险因素与术后并发症相关,这有助于指导未来的患者选择。

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