[1]蔡同川,王峰,翁梅,等.老年经皮椎体成形术围手术期隐性失血及其影响因素分析[J].中华老年骨科与康复电子杂志,2021,(01):34-39.[doi:10.3877/cma.j.issn.2096-0263.2021.01.007]
　Cai Tongchuan,Wang Feng,Weng Mei,et al.Perioperative hidden blood loss in elderly OVCF patients with percutaneous vertebroplasty and influencing factors[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2021,(01):34-39.[doi:10.3877/cma.j.issn.2096-0263.2021.01.007]
点击复制

老年经皮椎体成形术围手术期隐性失血及其影响因素分析()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2021年01期
页码:
34-39
栏目:
脊柱
出版日期:
2021-02-05

文章信息/Info

Title:
Perioperative hidden blood loss in elderly OVCF patients with percutaneous vertebroplasty and influencing factors
作者:
蔡同川1; 2; 王峰1; 2; 翁梅3; 冯新民2; 张亮2
116044 大连医科大学研究生院1；225001 扬州大学临床医学院脊柱外科2 ，手术麻醉科3
Author(s):
Cai Tongchuan1; 2;  Wang Feng1; 2;  Weng Mei3;  Feng Xinmin2;  Zhang Liang2
1Graduate School of Dalian Medical University, Dalian 116044, China; 2Department of Orthopedics, 3Department of Anesthesiology, Clinical Medical College of Yangzhou University, Yangzhou 225001, China
关键词:
骨质疏松症;  骨质疏松性骨折;  椎体成形术;  隐性失血
Keywords:
Osteoporosis;  Osteoporotic fractures;  Vertebroplasty;  Hidden blood loss
DOI:
10.3877/cma.j.issn.2096-0263.2021.01.007
文献标志码:
A
摘要:
目的 分析老年患者经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）围手术期隐性失血（HBL）情况及其相关影响因素。方法 回顾性选取2018年9月至2018年12月间扬州大学临床医学院收治的91例应用PVP治疗的OVCF老年患者。记录以下信息：身高、体重、症状持续时间、既往病史等基本信息；入院后即刻、术后第2天血红蛋白（Hb）及红细胞压积（Hct）；手术时间、术中失血量、术前及术后伤椎高度、骨水泥渗漏与否等。根据公式计算术后总失血量，再根据显性失血量及总失血量计算隐性失血量，并对隐性失血的相关影响因素进行统计学分析。结果 91例中男性25例，年龄61～87岁；女性66例，年龄60～91岁。91例患者显性失血量平均为（12±5）ml，隐性失血量平均为（294±192）ml，两者比较差异有统计学意义（P＜0.01）。多元线性回归分析发现症状持续时间短（P=0.024）、手术节段多（P=0.010）、手术时间长（P=0.013）、椎体高度丢失多（P=0.037）、椎体高度恢复好（P=0.003）及骨水泥渗漏（P=0.005）均会导致隐性失血量增加。而性别（P=0.193）、年龄（P=0.607）、BMI（P=0.913）、高血压病（P=0.539）、糖尿病（P=0.903）、骨折部位（P=0.768）及术中失血量（P=0.715）则与隐性失血量无相关性。 结论 老年患者PVP围手术期存在明显的隐性失血，新鲜骨折、多节段椎体骨折、手术时间较长、椎体高度丢失明显、椎体高度恢复更好及骨水泥渗漏是其独立危险因素。
Abstract:
Objective To analyse the perioperative hidden blood loss and its influencing factors in elderly patients with osteoporotic vertebral compression fracture (OVCF) treated by percutaneous vertebroplasty (PVP). Methods From September 2018 to December 2018, 91 OVCF patients treated with PVP were selected. The patient’s height, weight, duration of symptoms, previous medical history and other basic information were routinely record. The hemoglobin (Hb) and hematocrit (Hct) immediately after admission and the next day postoperative were recorded. The operation time, intraoperative blood loss, preoperative and postoperative vertebral height , and bone cement leakage were recorded. The total blood loss was calculated according to the Gross’s formula, and then the hidden blood loss (HBL) was calculated based on the total blood loss and the visible blood loss. The statistical analysis of the difference of the patients’ hidden blood loss was performed, and then influential factors were further analyzed by multivariate linear regression analysis and t test. Results The mean visible blood loss was (12±5) ml and hidden blood loss was (294±192) ml, the differences between the visible and hidden blood loss was statistically significant (P=0.000). According to the multiple linear regression analysis, fresh fracture and short duration of symptoms (P=0.024), the number of surgical segment (P=0.010), operation time (P=0.013), loss of vertebral height (P=0.037), recovery of vertebral height (P=0.003), and bone cement leakage (P=0.005) increased the amount of HBL. The gender (P=0.193), age (P=0.607), BMI (P=0.913), hypertension (P=0.539), diabetes (P=0.903), fracture site (P=0.768), and intraoperative blood loss (P=0.715) had no correlation with the amount of HBL. Conclusions There is obvious HBL during the perioperative period of PVP in elderly OVCF patients. Fresh fractures, multi-segment vertebral fractures, longer operation time, loss of vertebral height, better recovery of vertebral height and bone cement leakage increased perioperative hidden blood loss during PVP.

相似文献/References:

[1]马晓龙,刘强,吴斗,等.骨质疏松显微骨折早期发生发展过程的实验研究[J].中华老年骨科与康复电子杂志,2016,(03):129.[doi:10.3877/cma.j.issn.2096-0263.2016.03.001]
　Ma Xiaolong,Liu Qiang,Wu Dou,et al.Experimental study of osteoporotic microsurgery fractures in the early development process[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):129.[doi:10.3877/cma.j.issn.2096-0263.2016.03.001]
[2]柴仪,田伟明,温志刚.经皮椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折的疗效分析[J].中华老年骨科与康复电子杂志,2016,(03):150.[doi:10.3877/cma.j.issn.2096-0263.2016.03.005]
　Chai Yi,Tian Weiming,Wen Zhigang.Curative effective analysis of percutaneous kyphoplasty for osteoporotic vertebral compression fracture in senile patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):150.[doi:10.3877/cma.j.issn.2096-0263.2016.03.005]
[3]崔红旺,蒋电明.骨细胞程序性死亡在骨质疏松中作用的研究进展[J].中华老年骨科与康复电子杂志,2016,(03):181.[doi:10.3877/cma.j.issn.2096-0263.2016.03.011]
　Cui Hongwang,Jiang Dianming.Effect of the programmed cell death of osteocyte on osteoporosis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):181.[doi:10.3877/cma.j.issn.2096-0263.2016.03.011]
[4]李子怡,李玉坤.OPG/RANK/RANKL信号通路在骨质疏松症中的研究进展和应用[J].中华老年骨科与康复电子杂志,2017,(02):124.[doi:10.3877/cma.j.issn.2096-0263.2017.02.012]
　Li Ziyi,Li Yukun.Researching progress and application of OPG-RANK-RANKL signaling pathway in osteoporosis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):124.[doi:10.3877/cma.j.issn.2096-0263.2017.02.012]
[5]赵胜军,赵丽,金宝城,等.单侧与双侧经皮椎体后凸成形术治疗老年新鲜骨质疏松性椎体骨折的临床疗效[J].中华老年骨科与康复电子杂志,2017,(03):150.[doi:DOI：10.3877/cma.j.issn.2096-0263.2017.03.004]
　Zhao Shengjun,Zhao Li,Jin Baocheng,et al.Effectiveness of unilateral and bilateral percutaneous kyphoplasty for fresh senile osteoporotic vertebral compression fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):150.[doi:DOI：10.3877/cma.j.issn.2096-0263.2017.03.004]
[6]雷涛,申勇.老年骨质疏松性椎体骨折若干问题的探讨[J].中华老年骨科与康复电子杂志,2017,(04):248.[doi:10.3877/cma.j.issn.2096-0263.2017.04.010]
　Lei Tao,Shen Yong..A brief discussion of osteoporotic vertebral fractures in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):248.[doi:10.3877/cma.j.issn.2096-0263.2017.04.010]
[7]郝海虎,吴斗,朱剑,等.单双侧穿刺经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的对比研究[J].中华老年骨科与康复电子杂志,2017,(06):321.[doi:10.3877/cma.j.issn.2096-0263.2017.06.001]
　Hao Haihu,Wu Dou,Zhu Jian,et al.Contrastive analysis of the unipedicular and bipedicular kyphoplasty in treatment of osteoporotic vertebral compression fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):321.[doi:10.3877/cma.j.issn.2096-0263.2017.06.001]
[8]马树伟.球囊扩张椎体成形术治疗急性与亚急性期骨质疏松椎体压缩骨折的疗效对比[J].中华老年骨科与康复电子杂志,2017,(06):341.[doi:10.3877/cma.j.issn.2096-0263.2017.06.005]
　Ma Shuwei.Clinical efficacy of percutaneous kyphoplasty in the treatment of acute and subacute phase of osteoporotic vertebral compression fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):341.[doi:10.3877/cma.j.issn.2096-0263.2017.06.005]
[9]刘伟,傅光涛,胡旭民,等.唑来膦酸治疗绝经后骨质疏松发生脆性骨折的临床研究[J].中华老年骨科与康复电子杂志,2017,(06):351.[doi:10.3877/cma.j.issn.2096-0263.2017.06.007]
　Liu Wei,Fu Guangtao,Hu Xumin,et al.Analysis in postmenopausal osteoporosis patients with fragility fracture during zoledronic acid treatment[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):351.[doi:10.3877/cma.j.issn.2096-0263.2017.06.007]
[10]冯宪煊,施慧鹏,白跃宏.老年骨质疏松性骨折的康复治疗[J].中华老年骨科与康复电子杂志,2018,(01):48.[doi:10.3877/cma.j.issn.2096-0263.2018.01.011]
　Feng Xianxuan,Shi Huipeng,Bai Yuehong.Development in rehabilitation of senile osteoporotic fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(01):48.[doi:10.3877/cma.j.issn.2096-0263.2018.01.011]

备注/Memo

备注/Memo:
基金项目：江苏省青年医学重点人才项目（QNRC2016342）；江苏省妇幼健康科研重点资助项目（F201801）；江苏省高层次卫生人才“六个一工程”拔尖人才科研项目（LGY2019035）
更新日期/Last Update: 2021-03-26