Chinese Medical Sciences Journal ›› 2023, Vol. 38 ›› Issue (2): 109-116.doi: 10.24920/004154

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便秘与胸椎肿瘤患者下肢肌力下降的相关性:单中心回顾性横断面研究

刘勇*(),姚思远,周熹,刘书中,边焱焱   

  1. 中国医学科学院 北京协和医学院 北京协和医院骨科,北京 100730
  • 收稿日期:2022-08-11 接受日期:2023-01-13 出版日期:2023-06-30 发布日期:2023-04-04

Association Between Constipation and a Reduction in Lower Limb Muscle Strength in Preoperative Patients with Thoracic Spinal Tumors

Yong Liu*(),Si-Yuan Yao,Xi Zhou,Shu-Zhong Liu,Yan-Yan Bian   

  1. Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2022-08-11 Accepted:2023-01-13 Published:2023-06-30 Online:2023-04-04
  • Contact: *86-10-69152200, E-mail: liuyongxh@163.com

摘要:

目的 本研究旨在分析胸椎肿瘤患者下肢肌力下降的相关因素。

方法 我们回顾性分析于2011年1月至2021年5月在我院诊断为胸椎肿瘤患者的临床和影像学资料。排除主要病变位于胸腰椎、具有胃肠道手术史以及其他影响排便因素的病例。收集患者的年龄、性别、首发症状、病变表现、病程、尿潴留、下肢肌力和术前行走能力等情况,分析便秘组和无便秘组各参数的差异。采用多因素回归分析下肢肌力下降的危险因素。

结果 共纳入227例患者,其中男128例、女99例,平均年龄54.7(11~83)岁。便秘组和非便秘组分别为131和96例。便秘组患者术前出现行走困难或瘫痪的比例明显高于无便秘组患者(83.2%比17.7%, χ2 = 99.035,P < 0.001)。便秘(OR = 9.522,95%CI:4.150~21.849,P < 0.001)和尿潴留(OR = 14.490,95%CI:4.543~46.213,P < 0.001)分别是下肢肌力下降的独立危险因素。

结论 出现便秘症状的胸椎肿瘤患者有更高的下肢无力发生率。便秘和尿潴留是患者术前出现下肢肌力下降的独立危险因素。

关键词: 便秘, 胸椎肿瘤, 肌力下降, 术前, 手术干预

Abstract:

Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs.

Methods A single-center, retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021. The study involved a review of electronic medical records and radiographs and the collection of clinical data. The differences in clinical manifestations between patients with constipation and those without constipation were analyzed. Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.

Results A total of 227 patients were enrolled, including 131 patients with constipation and 96 without constipation. The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery (83.2% vs. 17.7%, χ2 = 99.035,P < 0.001). Constipation (OR = 9.522, 95%CI: 4.150-21.849, P < 0.001) and urinary retention (OR = 14.490, 95%CI: 4.543-46.213, P < 0.001) were independent risk factors for muscle strength decline in the lower limbs.

Conclusions The study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness. Moreover, the analysis revealed that constipation and urinary retention were independent risk factors associated with a preoperative decline in muscle strength of lower limbs.

Key words: constipation, thoracic spinal tumors, muscle strength decline, preoperation, surgical intervention

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