研究文章

椎体成形术后患者便秘危险因素：一项回顾性队列研究

庆裕 冯, 文伟 谢, 沛全 姚, 志婷 杨

9 卷, 10 期 (2026) 页码 1-5 开放存取

摘要

背景：骨质疏松性椎体压缩性骨折(OVCFs)常导致老年患者出现严重疼痛和功能障碍。经皮椎体成形术(PVP)虽已成为标准治疗方案，但术后便秘这一并发症的研究仍显不足，其临床影响不容忽视。方法：本回顾性研究分析了 2020-2025 年间496 例接受 PVP 治疗的OVCFs 患者。便秘诊断采用罗马 IV 标准。评估指标包括人口统计学特征、合并症、用药情况及手术相关因素，通过单因素和多因素 logistic回归分析确定危险因素。结果：便秘发生率为 46.76%(231/496) 。多因素分析确定 8 个独立危险因素(均 p<0.05)：住院时间延长(OR=1.049)、留置导尿管(OR=2.239)、高血压(OR=3.392)、慢性阻塞性肺疾病(OR=2.931)、冠心病(OR=5.540)、抗帕金森药物 (OR=26.656) 、阿片类药物 (OR=5.149) 和利尿剂 (OR=4.083) 。便秘患者住院时间显著延长(9±8.10 天 vs 7±6.59 天， p<0.05)。结论：PVP 术后便秘具有多因素致病特点，其中抗帕金森药物和心血管合并症的关联性尤为显著。研究结果强调需对高风险患者进行术前风险评估并制定个体化肠道管理方案。早期活动及合理用药或有助预防这一常见并发症。

关键词

椎体成形术；骨质疏松性骨折；术后并发症；便秘；危险因素

参考

Suzuki, N., Ogikubo, O. & Hansson, T. Te prognosis for pain, disability, activities of daily living and quality of life afer an acute osteoporotic vertebral body fracture: Its relation to fracture level, type of fracture and grade of fracture deformation.

Eur. Spine J. 18, 77–88 (2009).

Johansson, L., Sundh, D., Nilsson, M., Mellström, D. & Lorentzon, M. Vertebral fractures and their association with health-related quality of life,back pain and physical function in older women. Osteoporos. Int. 29, 89–99 (2018).

Gold, L. S. et al. Mortality among older adults with osteoporotic vertebral fracture. Osteoporos. Int. 34, 1561–1575 (2023).

Garfn, S. R., Buckley, R. A. & Ledlie, J. Balloon kyphoplasty for symptomatic vertebral body compression fractures results in rapid, signifcant, and sustained improvements in back pain, function, and quality of life for elderly patients. Spine 31, 2213–2220 (2006).

Beall, D. P. et al. Prospective and multicenter evaluation of outcomes for quality of life and activities of daily living for balloon kyphoplasty in the treatment of vertebral compression fractures: Te EVOLVE trial. Neurosurgery 84, 169–178 (2019).

Beall, D. P. et al. Prospective and multicenter evaluation of outcomes for quality of life and activities of daily living for balloon kyphoplasty in the treatment of vertebral compression fractures: Te EVOLVE trial. Neurosurgery 84, 169–178 (2019).

Clarençon, F. et al. Safety and clinical efectiveness of percutaneous vertebroplasty in the elderly (≥80 years). Eur. Radiol. 26, 2352–2358 (2016).

FitzHenry F, Eden SK, Denton J, Cao H, Cao A, Reeves R, Chen G, Gobbel G, Wells N, Matheny ME. Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort. Pain Res Manag. 2020 Mar 29;2020:5165682.

Deb B, Prichard DO, Bharucha AE. Constipation and Fecal Incontinence in the Elderly. Curr Gastroenterol Rep. 2020 Aug 24;22(11):54. doi: 10. 1007/s11894-020-00791- 1. PMID: 32839874.

Chen M, Yang C, Cai Z, Liu Y, Liu H, Cui J, Yao Z, Chen Y. Lumbar posterior group muscle degeneration: Influencing factors of adjacent vertebral body re-fracture after percutaneous vertebroplasty. Front Med (Lausanne). 2023 Apr 17;9:1078403. doi: 10.3389/fmed.2022.1078403

Kamei S, Noguchi T, Shida Y, Okafuji T, Yokoyama K, Uchiyama F, Nakatake H, Tajima T. The safety and efficacy of percutaneous vertebroplasty for patients over 90 years old. Jpn J Radiol. 2019 Feb;37(2):178- 185. doi: 10. 1007/s11604-018-0797- 1

Lin HS, Watts JN, Peel NM, Hubbard RE. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016 Aug 31;16(1):157. doi: 10. 1186/s12877-016-0329-8

Luo Q, Li Y, Guo J, Chen J, Chen Q, Sun M. Assessment and management of constipation in post-operative patients in the spinal surgery ward: a best practice implementation project. JBI Evid Implement. 2024 May 1;22(2):122- 130. doi: 10. 1097/XEB.0000000000000423

Sumida K, Molnar MZ, Potukuchi PK, Thomas F, Lu JL, Yamagata K, Kalantar-Zadeh K, Kovesdy CP. Constipation and risk of death and cardiovascular events. Atherosclerosis. 2019 Feb;281:114- 120. doi:10. 1016/j.atherosclerosis.2018.12.021

Lembo A, Cash BD, Lu M, Terasawa E, Terreri B, Du S, Ayyagari R, Feuerstadt P, Moshiree B, Westermeyer B, Pi S, Boules M. Clinical Outcomes Before and After Prucalopride Treatment: An Observational Study in Patients With Chronic Idiopathic Constipation in the United States. Clin Transl Gastroenterol. 2024 May 1;15(5):e00687. doi: 10. 14309/ctg.0000000000000687

O’Donnell MT, Haviland SM. Functional Constipation and Obstructed Defecation. Surg Clin North Am. 2024 Jun;104(3):565-578. doi: 10. 1016/j.suc.2023.11.007

G Rler H, Y Ld Z FT, Bekmez F. A Common Complication in Orthopedic Patients: Postoperative Constipation and Related Risk Factors. J Perianesth Nurs. 2023 Oct;38(5):e15-e20. doi: 10. 1016/j.jopan.2023.05.004

Ohkusa T, Koido S, Nishikawa Y, Sato N. Gut Microbiota and Chronic Constipation: A Review and Update. Front Med (Lausanne). 2019 Feb 12;6:19. doi: 10.3389/fmed.2019.00019

Takuma S, Mori K, Karayama M, Inoue Y, Yasui H, Hozumi H, Suzuki Y, Furuhashi K, Fujisawa T, Enomoto N, Inui N, Suda T. Association of constipation with the survival of patients with idiopathic interstitial pneumonias. Respir Investig. 2024 Nov;62(6):1204- 1208. doi:10. 1016/j.resinv.2024.10.010

Zhu Y, Ma G, Ren W, Hu Z, Zhou L, Zhang X, Zhao N, Zhang M, Yan L, Yu Q, Liu X, Chen J. Effect of oral probiotics on clinical efficacy and intestinal flora in elderly severe pneumonia patients. Medicine (Baltimore). 2023 Dec 1;102(48):e36320.doi:10. 1097/MD.0000000000036320

Wang R, Sun H, Yang T, Xu J. Causal relationship between hypertension and risk of constipation: A 2-way 2-sample Mendelian randomization study. Medicine (Baltimore). 2024 May 3;103(18):e38057. doi: 10. 1097/MD.0000000000038057

Mishima E. Constipation and high blood pressure variability. Hypertens Res. 2024 Feb;47(2):562-563. doi:10. 1038/s41440-023-01514-5

Refbacks

  • 当前没有refback。
版权所有（c）2026 庆裕 冯, 文伟 谢, 沛全 姚, 志婷 杨
Creative Commons License
此作品已接受知识共享署名-非商业性使用 4.0国际许可协议的许可。