摘要
目的 探讨胸腰椎骨折手术患者术中发生压力性损伤的高危影响因素.方法 回顾性分析聊城市中医医院2021年4月—2023 年 7 月收治的 108 胸腰椎骨折患者的临床资料.对患者的临床资料进行收集及整理,按照术中是否发生压力性损伤分为压力性损伤组(n=23)以及非压力性损伤组(n=85).先后采取单因素以及多因素logistic回归分析的方法分析影响胸腰椎骨折患者术中发生压力性损伤的高危影响因素.结果 共 23 例患者发生压力性损伤,其中位于额头部位最高,占43.48%(10/23)、下颌占 30.43%(7/23)、颊部占 13.04%(3/23)、前胸占 8.70%(2/23)、膝部占 4.35%(1/23).2 组年龄、身体质量指数(body mass index,BMI)、术前血清白蛋白(albumin,ALB)、麻醉类型、手术时间、术中使用的保护性材料、出血量比较,差异有统计学意义(P＜0.05).2 组性别、合并高血压、合并糖尿病、饮酒史、吸烟史、麻醉等级、麻醉类型、是否使用激素类药物、是否使用血管活性药物比较,差异无统计学意义(P＞0.05).logistic多因素分析显示,年龄、出血量、术前血清ALB可作为影响术中压力性损伤的高危因素(P＜0.05).结论 年龄、出血量、术前血清ALB可作为影响胸腰椎骨折手术压力性损伤的高危因素.
Abstract
Objective To explore the high risk influencing factors for intraoperative pressure injury in patients undergoing thoracolumbar spine fracture surgery.Methods A retrospective analysis was conducted on the clinical data of 108 patients with thoracolumbar vertebral fractures admitted to Liaocheng Traditional Chinese Medicine Hospital from April 2021 to July 2023.The clinical data of the patients were collected and organized,and they were divided into pressure injury group(n=23)and non pressure injury group(n=85)based on whether pressure injury occurred during surgery.Single factor and multiple factor logistic regression analysis were used to analyze the risk factors of intraoperative pressure injury in patients undergoing thoracolumbar spine fracture surgery.Results A total of 23 patients had stress injuries,of which the forehead was the highest,accounting for 43.48%(10/23),the mandibular accounts for 30.43%(7/23),the cheeks account for 13.04%(3/23),the anterior chest accounts for 8.70%(2/23)and the knee accounts for 4.35%(1/23).Age,body mass index(BMI),preoperative serum albumin(ALB),type of anesthesia,surgical time,protective materials used during the operation,and bleeding volume were compared between the two groups,and the differences were statistically significant(P<0.05).There was no significant difference between the two groups in terms of gender,hypertension,diabetes,drinking history,smoking history,anesthesia grade,anesthesia type,whether hormone drugs were used,and whether vasoactive drugs were used(P>0.05).Logistic multivariate analysis showed that the age,bleeding volume and preoperative serum ALB were the risk factors for intraoperative pressure injury(P<0.05).Conclusion Age,bleeding volume and preoperative serum ALB may be high-risk influencing factors for pressure injury in thoracolumbar spine fracture surgery.
维普
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