[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]
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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()
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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12王峰12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 Tongchuan12 Wang Feng12 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.

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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