| 摘要: |
| 目的 探究青少年特发性脊柱侧凸（AIS）患者基本情况、手术策略、术后情况对住院时长的影响。方法 回顾性纳入2014年1月1日至2023年12月31日于海军军医大学（第二军医大学）第一附属医院接受脊柱后路矫形融合内固定术治疗且随访至少2年的145例AIS患者为研究对象。根据手术策略，将患者分为选择性融合组（n＝50）和非选择性融合组（n＝95）。根据是否入住ICU，将患者分为入住ICU组（n＝81）和未入住ICU组（n＝64）。统计分析各分组患者的基本情况、手术情况、术后情况等相关参数，以及住院时长和术后住院时长。采用多重线性回归分析住院时长及术后住院时长的影响因素。结果 选择性融合组的手术节段数量、手术时间、术中出血量、术后第3天引流量、住院时长和术后住院时长均小于非选择性融合组（均P＜0.05）。入住ICU的患者相较于未入住ICU的患者年龄更小，手术时间更长，术中出血量和输血量更多，住院时长和术后住院时长更长（均P＜0.05）。相关性分析表明住院时长和术后住院时长均与入住ICU呈正相关（r＝0.179、0.240，均P＜0.05），均与选择性融合方式呈负相关（r＝－0.187、－0.242，均P＜0.05）。结论 脊柱后路矫形融合内固定术中采用非选择性融合方式的AIS患者住院时长和术后住院时长长于采用选择性融合方式的患者。采用非选择性融合方式、入住ICU可能是导致AIS患者住院时长及术后住院时长延长的因素。 |
| 关键词: 青少年特发性脊柱侧凸 选择性融合 住院时长 手术后并发症 |
| DOI：10.16781/j.CN31-2187/R.20240117 |
| 投稿时间：2024-02-20修订日期：2024-05-07 |
| 基金项目:海军军医大学（第二军医大学）第一附属医院面上项目（2023PY37）. |
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| Influencing factors of hospital stay after orthopedic surgery for adolescent idiopathic scoliosis |
| HUANG Shaokang,CHEN Kai,SHAO Jie,ZHAI Xiao,BAI Yushu* |
(Department of Spinal Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the influence of basic condition, surgical strategy, and postoperative condition of adolescent idiopathic scoliosis (AIS) patients on the length of hospitalization. Methods A total of 145 AIS patients who underwent posterior spinal fusion and internal fixation in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 1, 2014 to Dec. 31, 2023 with more than 2 years of follow-up were retrospectively enrolled. According to the surgical strategy, they were assigned to selective fusion group (n＝50) and non-selective fusion group (n＝95). AIS patients were assigned to intensive care unit (ICU) group (n＝81) and non-ICU group (n＝64) according to whether they were admitted to ICU. Parameters related to basic, surgical and postoperative conditions, hospital stay and postoperative hospital stay were analyzed. Multiple linear regression analysis was used to study the influencing factors of hospital stay and postoperative hospital stay. Results The number of surgical segments, surgical time, intraoperative blood loss, drainage volume on the 3rd day postoperatively, hospital stay, and postoperative hospital stay in the selective fusion group were significantly less than those in the non-selective fusion group (all P＜0.05). The patients in the ICU group were younger, had longer surgery time, had more intraoperative blood loss and blood transfusion, and had longer hospital stay and postoperative hospital stay compared with those in the non-ICU group (all P＜0.05). Correlation analysis showed that hospital stay and postoperative hospital stay were both positively correlated with ICU admission (r＝0.179, 0.240; both P＜0.05) and were both negatively correlated with selective fusion (r＝－0.187, －0.242; both P＜0.05). Conclusion The hospital stay and postoperative hospital stay of AIS patients with non-selective fusion in posterior spinal fusion and internal fixation is longer than those of patients with selective fusion. Non-selective fusion and ICU admission may be factors contributing to the prolonged hospital stay and postoperative hospital stay in AIS patients. |
| Key words: adolescent idiopathic scoliosis selective fusion hospital stay postoperative complications |
