骶骨肿瘤术后切口并发症的相关因素分析

目的分析骶骨肿瘤术后切口并发症的原因。方法2003年1月～2008年12月23例骶骨肿瘤行手术切除，手术时平均年龄42岁（16～68岁）；男性10例，女性13例。其中脊索瘤8例、骨巨细胞瘤6例、神经纤维瘤1例、恶性神经鞘瘤1例，转移瘤3例、骨母细胞瘤1例、骨肉瘤2例、软骨肉瘤1例。统计分析患者性别，年龄，肿瘤性质，有无糖尿病，肥胖，吸烟，是否应用激素，以前是否有过手术，放疗，术前是否行化疗，动脉栓塞，手术时间，出血量，手术入路，有无脑脊液漏，术后膀胱和肠道功能情况。应用Logistic回归分析了解以上因素与术后切口并发症的关系。结果6例患者（26％）术后出现切口并发症。增加并发症发生的因素有以前做过手术（P=0．016；OR8．01），手术时间〉3h（P=0.036；OR3．79），年龄〉50岁（P=0.076；OR1．59），术后膀胱和肠道功能障碍（P=0．089；OR2．53）。结论骶骨肿瘤切除手术切口并发症与再次手术，手术时间长，高龄患者以及术后膀胱和肠道功能障碍因素相关。

Analysis of factors related to surgical incision complication following sacral tumor resection

Objective To investigate the causes of sacral tumor surgical incision complication. Methods Between Jan. 2003 and Dec. 2008, 23 patients with sacral tumors underwent resection. They were 10 men and 13 women. The tumor was chordoma （n=8）, giant bone cell bone tumor （n=6）, neurofibroma （n=1）, malignant neurilimmoma （n=1）, metastases tumor （n=3）, osteoblastoma （n=1）, osteosarcoma （n=2）, and chondrosarcoma （n=1）. The related factors were analyzed, including their gender, age, nature of the tumor, the history of diabetes, obesity, smoking, hormone use, surgical treatment, radiotherapy, chemotherapy, arterial embolism, and the operation time, blood loss, surgical approach, cerebrospinal fluid leakage, and postoperative bowel and bladder function. Logistic regression analysis was implemented to find the relationship between of such factors and the presence of surgical incision complication. Results Six（26%） patients had incision complication after surgery. The risk factors to increase the risk of complication were previous surgeries （P= 0.016; OR8.01）, operation time which was long than 3 hours （P=0.036; OR3.79）, the age which was more than 50 （P=0.076; OR1.59）, and bowl and bladder dysfunction （P=0.089; OR2.53）. Conclusions The surgical incision complication of sacral tumor resection were related to long operation time, the patient＇s age and bowl and bladder dysfunction.