在小儿脑麻患者中进行脊柱关节切除后的再手术,再入院和术后出血
Michael J Miskiewicz1, Shabnam Parsa2, Matthew Magruder3
1Department of Orthopaedic Surgery, Stony Brook University, Stony Brook, USA.
Cureus
|July 18, 2024
概括
患有脑 (CP) 的儿童在脊髓融合手术后面临更高的并发症风险. 关键的风险因素包括老年,某些并发症和后部手术,需要量身定制的外科手术期间的策略.
科学领域:
- 儿科整形外科 儿科整形外科
- 神经外科 神经外科
- 公共卫生 公共卫生
背景情况:
- 大脑 (CP) 是一种常见的儿童神经肌肉疾病.
- 脊柱异常在患有CP的儿童中更为普遍.
- 在CP患者中增加术后并发症风险的术后因素需要进一步研究.
研究的目的:
- 为了确定小儿CP患者在脊髓融合后手术后并发症的发生率是否更高.
- 为了确定手术后出血,再入院和在经过脊髓融合的CP患者中重新手术的风险因素.
主要方法:
- 利用了2019年美国外科医生学院国家外科质量改进计划的儿科数据库.
- 用于人口统计和并发症比较的Chi-平方测试.
- 进行多变量后勤回归以确定复合术后并发症的独立风险因素.
主要成果:
- 包括606名CP患者和3839名非CP患者.
- CP队列中喘,胃肠道疾病,先前的心脏手术和血液学疾病的患病率较高.
- 脑筋梗塞,年龄较大,非高加索种族,美国麻醉学会 (ASA) 3+类,后部接近,先前的心脏手术和骨干是并发症的重要危险因素.
结论:
- 大脑是一种独立的风险因素,增加了术后并发症,包括出血,再入院和脊髓融合后的再手术.
- 年龄较大,非高加索种族,较高的ASA类,后部接近,先前的心脏手术和骨干也独立增加并发症风险.
- 需要进一步的研究,以开发外科手术期间的策略,以减轻这些风险的儿科CP患者进行脊髓融合.
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