摘要
目的:探讨脊柱结核患者术后恢复排气时间的影响因素。方法:采用前瞻性横断面研究的方法,连续纳入2021年2—12月在首都医科大学附属北京胸科医院骨科新入住且符合入组标准的75例脊柱结核患者作为研究对象。使用病例报告表收集患者基本情况、入院次日和术后次日的血常规和血生化、手术方式、手术时长、疼痛处理、术后口渴评分、术后疼痛评分、术中出血量、术中输血量等指标,以及是否参加营养管理。采用单因素和多元逐步回归模型探讨影响脊柱结核患者恢复排气时间的潜在因素。结果:75例脊柱结核患者术后恢复排气的时间范围为0.5~98.0 h,中位时间为27.0(19.0,40.0)h,≤24 h者仅29例(38.7%)。单因素分析显示,脊柱结核患者术后恢复排气时间与入院次日的血红蛋白水平[(124.1±17.2)g/L]呈负相关(r=-0.289,P=0.012),与术后2 h时的口渴评分[5.0(4.0,6.0)分]呈正相关(r=0.258,P=0.025);与其他因素均无相关性,如与是否进行营养管理[26.0(16.0,38.0)h和30.8(21.3,45.3)h]和术后24 h疼痛评分[4.0(3.0,6.0)分]均无相关性(Z=-1.915,P=0.056;r=0.171,P=0.143)。多元逐步回归分析显示,入院次日血红蛋白水平、术后24 h疼痛评分和是否进行营养管理均是脊柱结核患者术后恢复排气时间的潜在影响因素,且术后恢复排气时间随着血红蛋白水平的升高、营养管理的完善而缩短,随术后24 h疼痛评分的增加而延长(β=-0.349,P=0.002;β=3.143,P=0.003;β=-10.312,P=0.008)。结论:脊柱结核患者术后排气恢复时间较长,临床医护人员应关注入院时贫血、住院期间未进行全程营养管理,以及术后24 h疼痛评分较高的患者。
Objective:To explore the influencing factors of postoperative exhaust time in patients with spinal tuberculosis.Methods:A prospective cross-sectional study was conducted in 75 newly admitted patients with spinal tuberculosis from the Orthopedics Department of Beijing Chest Hospital,Capital Medical University between February and December 2021.All the patients met the inclusion criteria.The basic information of patients,routine blood test and blood biochemistry on the next day after admission and the next day after surgery,the procedure and duration of surgery,the management of pain,postoperative thirst scores,intraoperative bleeding and blood transfusion,etc.,as well as whether or not participate in nutritional management were collected by the case report form.Univariate correlation analysis and multiple stepwise regression analysis were performed to explore the potential influencing factors of exhaust time of patients with spinal tuberculosis.Results:The postoperative exhaust time of 75 patients with spinal tuberculosis ranged from 0.5 to 98.0 hours,and the median time was 27.0(19.0,40.0)hours.There were only 29 patients with exhaust time of≤24 hours(38.7%).The results of univariate correlation analysis showed that the postoperative exhaust time in patients with spinal tuberculosis was negatively correlated with the concentration of hemoglobin at admission((124.1±17.2)g/L)(r=-0.289,P=0.012)and positively correlated with the thirst score 2 hours after surgery(5.0(4.0,6.0))(r=0.258,P=0.025),but not significantly correlated with other factors.For example,the postoperative exhaust time in patients was not significantly correlated with nutrition management(26.0(16.0,38.0)h and 30.8(21.3,45.3)h)(Z=-1.915,P=0.056)or pain score 24 hours after surgery(4.0(3.0,6.0)score)(r=0.171,P=0.143).The results of the multiple stepwise regression showed that the concentration of hemoglobin at admission(β=-0.349,P=0.002),pain score 24 hours after surgery(β=3.143,P=0.003),and nutritional management(β=-10.312,P=0.008)were the infl
作者
张亚超
李卓
陈洋
马皎洁
雷国华
ZHANG Ya-chao;LIZhuo;CHEN Yang;MA Jiao-jie;LEI Guo-hua(Department of Orthopedic,Beijing Chest Hospital,Capital MedicalUniversity,Beijing 101149,China;Department of Clinical Nutrition,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)
出处
《中国防痨杂志》
CAS
CSCD
2022年第6期570-575,共6页
Chinese Journal of Antituberculosis
关键词
结核
脊柱
排气时间
因素分析
统计学
Tuberculosis,spinal
Postoperative exhaust time
Factor analysis,statistical
