目的 探讨术前低白蛋白血症与后路腰椎融合术（posterior lumbar interbody fusion，PLIF）后不良结局发生率的相关性。 方法 选取珠江医院2017年1月~2019年12月接受后路腰椎融合术治疗的腰椎退行性疾病患者1372例，男597例，女775例，平均年龄（58.11±12.56）岁，根据术前血清白蛋白（albumin，ALB）水平，分为低白蛋白组（ALB<35 g/L，n=91）和正常白蛋白组（ALB≥35 g/L，n=1281），比较两组患者术后3个月内发生的不良结局（术后转ICU监护、术后特定并发症、再次入院、切口感染、愈合不良等），通过logistic多元回归分析模型及混杂因素调整来评估术前血清白蛋白水平与术后不良结局之间的关系及术前低白蛋白血症与术后不良结局发生率的相关性。 结果 术前白蛋白水平与术后不良结局的发生密切相关（OR＝0.94；95% CI：0.90~0.98；P<0.05），术前低白蛋白组患者发生术后不良结局的风险是术前正常白蛋白组的2.15倍（OR＝2.15；95% CI：1.21~3.79；P<0.05）。 结论 术前低白蛋白血症患者会显著增加PLIF术后不良结局的发生率，术前血清白蛋白水平可作为预测PLIF术后不良结局发生的重要参考指标。
Abstract
Objective To investigate the correlation between preoperative hypoalbuminemia and prevalence of adverse events after posterior lumbar interbody fusion (PLIF). Methods Patients diagnosed with lumbar degeneration disease (LDD) who underwent PLIF in our hospital from January 2017 to December 2019 were selected and categorized based on preoperative serum albumin concentration: a low albumin group (n=91, ALB<35g/L); a normal albumin group (n=1281, ALB≧35g/L). The adverse events within 3 months after operation were recorded and compared, including: transfer to the intensive care unit (ICU) for monitoring transition, postoperative specific complications, readmission, incision infection, and poor healing. Multivariable logistic regression analysis model adjusting confounders was used to assess the relationship between preoperative serum albumin levels and adverse postoperative outcomes, and the relationships between preoperative hypoalbuminemia and rates of adverse postoperative outcomes. Results A total of 1372 patients, including 597 males and 775 females, with the average age (58.11±12.56) years old data study showed that preoperative albumin levels were closely related to the occurrence of adverse postoperative outcomes (OR=0.94; 95%CI: 0.90~0.98; P<0.05). Compared with patients in the preoperative normal albumin group, the risk of adverse postoperative outcomes in the preoperative low albumin group was 2.15 times that of the normal albumin group (OR=2.15; 95% CI: 1.21~3.79; P<0.05). Conclusions Patients with preoperative hypoalbuminemia will significantly increase the incidence of adverse outcomes after PLIF. The preoperative serum albumin level can be used as an important reference index for predicting adverse outcomes after PLIF.
关键词
腰椎退行性疾病； /
/
低白蛋白血症； /
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后路腰椎融合术； /
/
不良结局
Key words
Lumbar degenerative disease; /
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Hypoalbuminemia; /
Posterior lumbar fusion; /
Adverse outcome
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基金
广东省自然科学基金项目（2017A030313564）；国家重点研发计划资助（2017YFC1105000）
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