关键词: 青少年特发性脊柱侧凸, 首次离床活动, 直立不耐受, 影响因素

Abstract:

Objective The aim of this study was to explore the influencing factors of orthostatic intolerance in adolescent idiopathic scoliosis patients after surgery for the first time out of bed movement. Methods A retrospective analysis was conducted on the clinical data of 226 adolescent idiopathic scoliosis patients admitted to Nanjing Drum Tower Hospital from June 2021 to June 2023. Based on whether upright intolerance occurred during the first postoperative ambulation， patients with upright intolerance were included in the upright intolerance group， and patients without upright intolerance were included in the non upright intolerance group. Collect general data of two groups of patients， as well as their blood pressure at different positions during their first postoperative out of bed activity. Conduct univariate and multivariate logistic regression analysis on the influencing factors of upright intolerance during their first postoperative out of bed activity in adolescent idiopathic scoliosis patients. Results Out of 226 patients who underwent their first postoperative ambulation， 102 experienced orthostatic intolerance， accounting for 45.13% （102/226） of the cases. The systolic and diastolic blood pressure in both sitting and standing positions were lower in the orthostatic intolerance group than in the non orthostatic intolerance group （P < 0.05）. Through univariate analysis， it can be seen that the postoperative bed rest time， sitting pain score， standing pain score， postoperative hospitalization time， and proportion of posture adaptation training in the orthostatic intolerance group were significantly different from those in the non orthostatic intolerance group （P < 0.05）. Through multiple logistic regression analysis， it can be seen that long postoperative bed rest time， degree of sitting pain， degree of standing pain， and lack of posture adaptation training are risk factors for upright intolerance （P < 0.05）. Conclusion Long postoperative bed rest time， sitting pain， standing pain， and lack of posture adaptation training are the main risk factors affecting upright intolerance of adolescent idiopathic scoliosis patients after surgery for the first time out of bed activity.

Key words: adolescent idiopathic scoliosis, first time out of bed activity, erectile intolerance, influence factor