摘要
目的观察骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures, OVCFs病人行经皮椎体后凸成形术(percutaneous kyphoplasty, PKP)的隐性失血情况,并分析其影响因素。方法选取2016年9月至2018年5月行PKP手术的100例OVCFs病人进行回顾性分析。根据病人的身高、体重、术前和术后红细胞比容(Hct)、血红蛋白水平计算失血量。收集病人的性别、年龄、身体质量指数(body mass index, BMI)、椎体高度压缩率、椎体高度恢复率、骨折节段数、骨密度、骨水泥渗漏、高血压、糖尿病、手术时间,并分析其与隐性失血量的相关性。结果本组病人PKP术后的隐性失血量为(293±101)ml,术后血红蛋白丢失量是(8.1±3.5)g/L。单因素分析结果显示手术时间、手术节段、椎体高度恢复率、椎体高度压缩率、骨水泥渗漏、骨密度T值、合并高血压是影响隐性失血量的相关因素。多元线性回归分析结果显示,手术节段数(P=0.008)、椎体高度压缩率(P=0.005)、椎体高度恢复率(P=0.016)、骨水泥渗透(P=0.038)与隐性失血量呈正相关性。结论 PKP术前,应重点关注手术节段数多、椎体高度压缩率高的病人,提高手术评估能力,保障病人的临床安全。
Objective To observe the hidden blood loss(HBL) in patients with osteoporotic vertebralcompression fractures(OVCFs) undergoing percutaneous kyphoplasty(PKP), and to analyze the influencingfactors. Methods From September 2016 to May 2018, 100 patients with OVCFs who were scheduled to have aPKP were enrolled in this study. Different factors, including gender, age, body mass index(BMI), percentage ofvertebral height restoration, number of fracture levels, bone mineral density(BMD), hypertension, diabetesmellitus, operative time, percentage of vertebral height compression, and cement leakage were examined.According to Gross.s formula, each patient.s height, weight, and preoperative and post-operative hematocrit wererecorded and used for calculating the blood loss. Influential factors were further analyzed by multivariate linearregression analysis. Results The HBL was(293±101) ml and the post-operative Hb loss was(8.1±3.5) g/L.The results of univariate analysis showed that operative time, number of fracture levels, percentage of vertebralheight compression, percentage of vertebral height restoration, cement leakage, BMD and hypertension were therelated factors to the HBL. Multivariate linear regression analysis revealed that HBL was positively associatedwith percentage of vertebral height compression, percentage of vertebral height restoration and cement leakage.By contrast, HBL was not associated with gender, age, BMD, hypertension, diabetes mellitus, BMI and operativetime. Conclusion HBL cannot be ignored in perioperative period, especially for the patients with poorphysical condition and multiple fractures. Having a correct understanding of HBL can help improve clinicalassessment capabilities, ensuring patients. safety.
作者
吴君豪
陈扬
袁俊虎
苏萌
魏鲁青
陈显辉
张建平
WU Jun-hao;CHEN Yang;YUAN Jun-hu;SU Meng;WEI Lu-qing;CHEN Xian-hui;ZHANG Jian-ping(Shenzhen Second People's Hospital, Clinical Medicine College of Anhui Medical University, Shenzhen 518000,China;Department of Orthopaedics, Foshan First People's Hospital,Foshan 528000,China)
出处
《骨科》
CAS
2019年第3期201-204,共4页
ORTHOPAEDICS
关键词
隐性失血
经皮椎体后凸成形术
骨质疏松压缩性骨折
影响因素
多元线性回归分析
失血
手术
Hidden blood loss
Percutaneous kyphoplasy
Osteoporotic vertebral compression fractures
Influencing factors
Multivariate linear regression analysis
Blood loss,surgical
