儿童发育性髋关节脱位骨盆截骨术后早期发热的危险因素分析

Analysis in risk factors of fever in early stage after pelvic osteotomy for developmental dislocation of hip in children

  • 摘要:
      目的  探讨儿童发育性髋关节脱位骨盆截骨术后早期发热的危险因素。
      方法  回顾性分析142例儿童发育性髋关节脱位(采用Salter骨盆截骨+髋关节切开复位+股骨短缩旋转截骨术)的临床资料。将患儿根据术后早期发热情况分为发热组(n=87)与非发热组(n=55)。比较2组患儿性别、年龄、手术持续时间、体质量、麻醉方式、术后第1天血红蛋白、术后第1天胸片结果、术后第1天白细胞计数、术后第1天降钙素原水平及血C反应蛋白水平等指标。
      结果  单因素分析结果显示,年龄、术后血红蛋白、体质量是影响儿童骨盆截骨术后早期发热的重要因素(P < 0.05)。多因素Logistic回归分析结果显示,术后血红蛋白≤80 g/L是儿童骨盆截骨术后早期发热的独立危险因素。
      结论  儿童发育性髋关节脱位骨盆截骨术后出现早期发热的相关危险因素有体质量≤15 kg、年龄≤3岁、术后血红蛋白≤80 g/L, 其中术后血红蛋白≤80 g/L是儿童骨盆截骨术后早期发热的独立危险因素。

     

    Abstract:
      Objective  To explore the risk factors of fever in early stage after pelvic osteotomy for developmental dislocation of hip in children.
      Methods  Clinical materials of 142 children with developmental dislocation of hip were analyzed retrospectively, and all the children were treated with Salter pelvic osteotomy plus hip joint open reduction plus femoral shortening rotary osteotomy. The children were divided into fever group (n=87) and non-fever group (n=55) according to the early fever after operation. The gender, age, duration of operation, body mass, anesthesia method, hemoglobin on the first day after operation, chest X-ray result on the first day after operation, white blood cell count on the first day after operation, procalcitonin level and C-reactive protein level on the first day after operation were compared between the two groups.
      Results  Univariate analysis showed that age, hemoglobin level and body mass were important influencing factors of early fever after pelvic osteotomy in children (P < 0.05). Multivariate Logistic regression analysis showed that post-operative hemoglobin ≤ 80 g/L was an independent risk factor of early fever after pelvic osteotomy in children.
      Conclusion  The risk factors of early fever after pelvic osteotomy for developmental dislocation of the hip in children are body mass ≤ 15 kg, age ≤ 3 years, and post-operative hemoglobin ≤ 80 g/L. Postoperative hemoglobin ≤ 80 g/L is an independent risk factor for early fever after pelvic osteotomy in children.

     

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