骨转移瘤患者术后神经功能恢复的影响因素分析

目的:探讨骨转移瘤患者术后神经功能恢复的影响因素。方法:选取我院于2013年2月至2018年8月期间收治的骨转移瘤患者143例，分析患者术后神经功能恢复情况。采用单因素和多因素Logistic回归分析影响术后神经功能恢复危险因素。结果:143例骨转移瘤患者中，发生神经功能障碍34例，发生率为23.78%。单因素分析结果显示，两组性别、平均BMI、原发性恶性肿瘤类型、手术方式、术前放疗、骨科并发症和肿瘤直径比较差异无统计学意义（P＞0.05）；年龄＞60岁、术前即有神经损伤、术中神经牵拉和肿瘤快速进展的患者组术后发生神经功能障碍的百分率高于年龄≤60岁、术前没有神经损伤、术中未发生明显神经牵拉和肿瘤进展相对较慢患者组，差异具有统计学意义（P＜0.05）。将上述单因素分析具有统计学意义的纳入Logistic回归分析显示，年龄＞60岁、神经损伤、牵拉神经和肿瘤进展快速为影响术后神经功能恢复独立危险因素。结论:骨转移瘤患者术后神经功能恢复受多因素影响，为提高患者术后神经功能恢复，应采取针对性预防措施。

Influencing factors of postoperative neurological function recovery in patients with bone metastases

Objective:To investigate the factors influencing postoperative neurological function recovery in patients with bone metastases.Methods:143 patients with bone metastases admitted to our hospital from February 2013 to August 2018 were selected and their neurological function recovery was analyzed.Univariate and multivariate Logistic regression analysis was used to analyze the risk factors for postoperative neurological recovery.Results:Among 143 patients with bone metastases,34 patients developed neurological dysfunction,with a 23.78% incidence.Univariate analysis showed that there was no significant difference in gender,mean BMI,primary malignant tumor,surgical type,preoperative radiotherapy,orthopaedic complications and tumor diameter between the two groups (P＞0.05).The age of neurological dysfunction group which was more than 60 years old were more than that of non-neurological dysfunction group,and nerve injury was more than that of non-neurological dysfunction group.The percentage of nerve pulling was more than that of the group without nerve dysfunction,and the tumor progressed more rapidly than that of the group without nerve dysfunction (P＜0.05).Logistic regression analysis showed that age >60,nerve injury,traction nerve and tumor progression were independent risk factors for postoperative neurological function recovery.Conclusion:Postoperative neurological recovery of patients with bone metastases is affected by many factors.In order to improve postoperative neurological recovery,preventive measures should be taken.