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先天性脊柱侧凸后路手术延迟拔管的危险因素分析:一项回顾性队列研究

Analyzing Risk Factors for Delayed Extubation Following Posterior Approach Surgery for Congenital Scoliosis: A Retrospective Cohort Study.

作者信息

Cui Jian, Zhang Jingjing, Li Wenzhe, Liu Wei, Wang Yixi, Xu Tao, Wang Yi, Yu Xiangyou

机构信息

Department of Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.

Xinjiang Key Laboratory of Medical Animal Model Research, Urumqi, China.

出版信息

Global Spine J. 2025 May;15(4):2051-2061. doi: 10.1177/21925682241282275. Epub 2024 Sep 2.

DOI:10.1177/21925682241282275
PMID:39223805
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11571709/
Abstract

Study DesignRetrospective cohort study.ObjectivesInvestigate the risk factors for delayed extubation after posterior approach orthopedic surgery in patients with congenital scoliosis.MethodsThe clinical data of patients who received surgery for congenital scoliosis at the First Affiliated Hospital of Xinjiang Medical University between January 2021 and July 2023 have been gathered. Patients are categorized into the usual and the delayed extubation groups, depending on the duration of tracheal intubation after surgery. The study employs univariate and multivariate logistic regression models to examine the clinical characteristics of the two cohorts and discover potential risk factors linked to delayed extubation. In addition, a prediction model is created to visually depict the significance of each risk factor in terms of weight according to the nomogram.ResultsA total of 119 patients (74.8% females), with a median age of 15 years, are included. A total of 32 patients, accounting for 26.9% of the sample, encountered delayed extubation. Additionally, 13 patients (10.9%) suffered perioperative complications, with pneumonia being the most prevalent. The multivariate regression analysis revealed that the number of osteotomy segments, postoperative hematocrit, postoperative Interleukin-6 levels, and weight are predictive risk factors for delayed extubation.ConclusionsPostoperative hematocrit and Interleukin-6 level, weight, and number of osteotomy segments can serve as independent risk factors for predicting delayed extubation, with combined value to assist clinicians in evaluating the risk of delayed extubation of postoperative congenital scoliosis patients, improving the success rate of extubation, and reducing postoperative treatment time in the intensive care unit.

摘要

研究设计

回顾性队列研究。

目的

调查先天性脊柱侧凸患者后路矫形手术后拔管延迟的危险因素。

方法

收集了2021年1月至2023年7月在新疆医科大学第一附属医院接受先天性脊柱侧凸手术患者的临床资料。根据术后气管插管时间,将患者分为常规拔管组和延迟拔管组。本研究采用单因素和多因素logistic回归模型,以检验两组患者的临床特征,并发现与拔管延迟相关的潜在危险因素。此外,根据列线图创建预测模型,直观描述各危险因素在权重方面的重要性。

结果

共纳入119例患者(女性占74.8%),中位年龄为15岁。共有32例患者(占样本的26.9%)出现拔管延迟。此外,13例患者(10.9%)发生围手术期并发症,其中肺炎最为常见。多因素回归分析显示,截骨节段数、术后血细胞比容、术后白细胞介素-6水平和体重是拔管延迟的预测危险因素。

结论

术后血细胞比容、白细胞介素-6水平、体重和截骨节段数可作为预测拔管延迟的独立危险因素,联合应用有助于临床医生评估先天性脊柱侧凸患者术后拔管延迟的风险,提高拔管成功率,缩短重症监护病房的术后治疗时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66bc/12035088/17cc9fe63e7f/10.1177_21925682241282275-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66bc/12035088/6004b42f2c8b/10.1177_21925682241282275-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66bc/12035088/17cc9fe63e7f/10.1177_21925682241282275-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66bc/12035088/6004b42f2c8b/10.1177_21925682241282275-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66bc/12035088/17cc9fe63e7f/10.1177_21925682241282275-fig2.jpg

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本文引用的文献

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Incidence of genitourinary anomalies in congenital scoliosis: systematic review and meta-analysis.先天性脊柱侧凸患者泌尿生殖系统异常的发生率:系统评价和荟萃分析。
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Development of a Prediction Score for Evaluation of Extubation Readiness in Neurosurgical Patients with Mechanical Ventilation.开发一种预测评分系统,用于评估机械通气神经外科患者的拔管准备情况。
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