急性脊髓损伤患者早期并发症影响因素的临床研究

Clinical study of risk factors for early complication in acute spinal cord injury

关键词:  急性脊髓损伤  并发症  影响因素

Key words:  [Key words]　spinal cord injury  complication  risk factor

摘要:

[摘要]　目的　探索急性脊髓损伤患者早期并发症的影响因素，为改善该病的预后提供依据。　方法　收集416例急性脊髓损伤患者的临床资料。统计性别、年龄、损伤类型、损伤节段、是否进行过手术、是否使用激素治疗、是否发生并发症和并发症类型等指标。对所有影响因素先进行单因素分析筛选，计数资料的比较采用χ 2检验，将P<0.05的因素纳入非条件logistic回归模型进行分析，采用backward conditional法；检验水准α=0.05。　结果　早期并发症发生率为19.95%，发生较多的为肺部感染，低钠血症，泌尿系统感染和心血管病系统并发症。年龄≥60岁、完全性损伤、损伤节段为颈段及胸段和应用激素为急性脊髓损伤患者发生早期并发症的影响因素。　结论　急性脊髓损伤早期并发症的发生与年龄、损伤类型、损伤节段和激素治疗有关，应注意预防其并发症发生，改善患者预后。

Abstract:

[Abstract] Objective　To study possible risk factors of early complication in Acute Spinal Cord Injury using matched retrospective study and Logistic regression analysis.　Methods　Clinical information were collected from 416 spinal cord injury patients,including gender,age,type and level of injury,surgery,glucocorticoid used and early complications. Using chi-square test and single factor analysis,all statistical significant factors (P<0.05) were included into unconditioned logistic regression model. A backward conditional method was used. A p value less than 0.05 was considered as statistically significant when two-sided tests were performed.　Results　Incidence rate of early complication was 19.95%. The most common early complications were pulmonary infection,hyponatremia,urinary system infection and cardiovascular system complications. Age ≥60,complete spinal cord injury,injury in cervical and thoracic vertebra and glucocorticoid used were risk factors for early complication in acute spinal cord injury.　Conclusion　Early complication of acute spinal cord injury is affected by age,type and level of injury and glucocorticoid use.