Xu Xinke,Lin Haoming,Lin Wei,et al.Risk factors of secondary operation for craniosynostosis in children[J].Journal of Clinical Pediatric Surgery,2024,(02):125-129.[doi:10.3760/cma.j.cn101785-202312002-005]
儿童颅缝早闭二次手术影响因素分析
- Title:
- Risk factors of secondary operation for craniosynostosis in children
- Keywords:
- Craniosynostoses; Surgical Procedures; Operative; Reoperation; Treatment Outcome; Root Cause Analysis; Child
- 摘要:
- 目的 探讨儿童颅缝早闭手术后二次手术的影响因素。方法 回顾性分析广州市妇女儿童医疗中心神经外科于2016年3月至2023年8月采取手术治疗的儿童颅缝早闭患儿临床资料,按是否接受二次手术分成一次手术组及二次手术组。收集两组患儿性别、年龄、颅缝早闭类型、手术方式、手术时间、出血量等,并对可能导致二次手术的影响因素进行分析。结果 共纳入儿童颅缝早闭133例,其中119例接受一次手术(为一次手术组),14例接受二次手术(为二次受试组)。单因素分析提示,二次手术组患儿中单纯行颅缝切开术人数占比明显高于一次手术组,差异有统计学意义(50.0%比11.8%,χ2=11.047,P=0.001);二次手术组第一次手术时年龄［7.50(3.75,10.00)个月］小于一次手术组［11(6,25)个月］,差异有统计学意义(Z=-2.39,P=0.017);二次手术组第一次手术时体重［6.75(6.00,8.25)kg］低于一次手术组［9(7,11)kg］,差异有统计学意义(Z=-3.195,P=0.001);二次手术组第一次手术时间［120(73.75,185.00)min］少于一次手术组［190(135,245)min］,差异有统计学意义(Z=-2.494,P=0.013);二次手术组患儿第一次手术出血量［100(50,200)mL］少于一次手术组［200(100,300)mL］,差异有统计学意义(Z=-2.374,P=0.018)。进一步的多因素分析显示,单纯行颅缝切开术可能是二次手术的影响因素(OR=4.406,95%CI 1.038-18.708,P=0.044)。结论 手术是治疗颅缝早闭的有效方法。手术方式可能是患儿是否需要二次手术的影响因素,单纯行颅缝切开术可能需要接受二次手术,在制定治疗方案时应予适当考虑。
- Abstract:
- Objective To explore the influencing factors of secondary operation after craniosynostosis in children.Methods From March 2016 to August 2023,the relevant clinical data were retrospectively reviewed for 133 children with craniosynostosis undergoing surgery.They were divided into primary surgery group and secondary surgery group according to whether they received the second surgery or not.Gender,age,type of craniosynostosis,operative approach,operative duration and volume of blood loss were recorded.The possible influencing factors of secondary operation were examined.Results Operation was one-time (n=119) and secondary (n=14).Univariate analysis suggested that the proportion of simple craniosynostomy in the secondary surgery group ［7(50.0%)］ was significantly higher than that in the single surgery group ［14(11.8%)］,and the difference was statistically significant (χ2=11.047,P=0.001); the age of the first surgery in the secondary surgery group［7.50(3.75,10.00)months］ was lower than that in the single surgery group ［11(6,25)months］,and the difference was statistically significant (Z=-2.39,P=0.017); the weight of the first surgery in the secondary surgery group ［6.75(6.00,8.25)kg］ was lower than that in the single surgery group ［9(7,11)kg］,and the difference was statistically significant (Z=-3.195,P=0.001); the time of the first surgery in the secondary surgery group ［120(73.75,185.00)min］ was lower than that in the single surgery group ［190(135,245)min］,and the difference was statistically significant (Z=-2.494,P=0.013); The first intraoperative blood loss in the secondary surgery group ［100(50,200)mL］ was lower than that in the simple surgery group ［200(100,300)mL］,and the difference was statistically significant (Z=-2.374,P=0.018).Further multivariate analysis showed that craniosynostomy alone may be a factor influencing the secondary operation (OR=4.406,95%CI:1.038-18.708,P=0.044).Conclusions Craniosynostosis is a common neurological congenital disease in children and surgery is efficacious.Surgical approach is an risk factor for secondary surgery.Simple suturectomy may require secondary operation and it should be properly considered in surgical planning.
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备注/Memo
收稿日期:2023-12-1。
基金项目:广州市科技计划项目(2023A03J0897)
通讯作者:李方成,Email:sjwklfc@126.com