Abstract:

Objective　By conducting targeted monitoring of postoperative pneumonia (POP) of spinal surgery, to analyze the incidence and risk factors of POP in spinal surgery patients. Methods　A total of 300 patients who underwent spinal surgery in China Guihang Group 302 Hospital from January 2021 to June 2022 were selected for retrospective analysis, who were all given targeted monitoring of spinal surgery POP. They were divided into 21 cases in the POP group and 279 cases in the non-POP group based on the presence or absence of POP. In the POP group, there were 13 males and 8 females, 9 cases <60 years old and 12 cases ≥60 years old. In the non-POP group, there were 161 males and 118 females, 156 cases <60 years old and 123 cases ≥60 years old. The risk factors of POP of spinal surgery were analyzed. χ² test was used for the count data, and binary logistic regression analysis was used for risk factor analysis. Results　Univariate analysis showed that there were no statistically significant differences in the age, gender, body mass index (BMI), surgical site, surgical approach, dural incision, bone grafting, cerebrospinal fluid leakage, secondary surgery, hypertension, cardio-cerebrovascular disease, liver disease, kidney disease, anemia, smoking history, and drinking history between the two groups (all P>0.05); operation time, operation type, standardized use of antibiotics, internal fixation, allogeneic blood transfusion, length of hospital stay, and diabetes mellitus might be the influencing factors of POP of spinal surgery (χ²=10.603, 13.177, 8.170, 5.666, 14.338, 12.079, and 5.172; all P<0.05). Binary logistic regression analysis showed that operation time ≥3 h, allogeneic blood transfusion, hospital stay ≥10 d, and diabetes were the risk factors for POP of spinal surgery (all OR>1, P<0.05), while selective surgery and standardized use of antibiotics were the protective factors for POP of spinal surgery (both OR<1, P<0.05). Conclusion　The occurrence of POP in spine surgery is related to operation time ≥3 h, allogeneic blood transfusion, hospital stay ≥10 d, and diabetes. Selective surgery and standardized use of antibiotics can reduce the occurrence of POP in spine surgery.

Key words:

Postoperative pneumonia, Spinal surgery, Target monitoring, Influencing factors

摘要：

目的　通过开展脊柱手术术后肺炎（POP）的目标性监测，分析脊柱手术患者POP发生率及其危险因素。方法　回顾性分析2021年1月至2022年6月在中国贵航集团三〇二医院行脊柱手术患者300例，均给予脊柱手术POP的目标性监测，按照有无发生POP分为POP组（21例）和非POP组（279例）。其中POP组男13例、女8例，年龄<60岁9例、≥60岁12例；非POP组男161例、女118例，年龄<60岁156例、≥60岁123例。分析脊柱手术POP的危险因素。计数资料采用χ²检验，危险因素分析采用二元logistic回归分析。结果　单因素分析显示，两组患者年龄、性别、体质量指数（BMI）、手术部位、手术入路、硬膜切开、植骨、脑脊液漏、二次手术、高血压、心脑血管病、肝病、肾病、贫血、吸烟史、饮酒史比较，差异均无统计学意义（均P>0.05）；手术时间、手术类型、规范使用抗菌药物、内固定、异体输血、住院时间、糖尿病是脊柱手术POP的影响因素（χ²=10.603、13.177、8.170、5.666、14.338、12.079、5.172，均P<0.05）。经二元logistic回归分析，手术时间≥3 h、异体输血、住院时间≥10 d、糖尿病是脊柱手术POP的危险因素（均OR>1，P<0.05）；手术类型为择期、规范使用抗菌药物是脊柱手术POP的保护因素（均OR<1，P<0.05）。结论　脊柱手术POP的发生与手术时间≥3 h、异体输血、住院时间≥10 d、糖尿病有关，择期选择手术、规范使用抗菌药物可降低脊柱手术POP的发生。

关键词:

术后肺炎, 脊柱手术, 目标监测, 影响因素