摘要
目的:探讨骨质疏松性椎体压缩性骨折在椎体后凸成形术后隐性失血及相关危险因素。方法:对2015年3月至2017年12月收治的153例骨质疏松性椎体压缩性骨折并接受椎体后凸成形术患者的临床资料进行回顾性分析,其中男55例,女98例;年龄68~87(78.6±11.4)岁。收集患者手术前后红细胞比容用于计算隐性失血量,通过多元线性回归模型分析患者的性别、年龄、体重指数、骨密度、是否合并糖尿病和高血压、手术方式(单侧或双侧)、手术时间、手术节段及数量、椎体丢失高度及恢复高度比因素对于隐性失血的影响。结果:术后隐性失血量为(287.7±68.5) ml。多元线性回归分析显示糖尿病病史(β=2.405,P=0.012),手术方式(β=3.042,P<0.001),手术时间(β=2.043,P=0.038),手术节段(β=1.993,P=0.043)及数量(β=0.374,P<0.001),椎体高度丢失(β=2.785,P=0.003)及恢复比例(β=7.301,P<0.001)与隐性失血相关。结论:骨质疏松性椎体压缩性骨折椎体后凸成形术存在一定程度的隐性失血,糖尿病病史、手术方式、手术时间、手术节段及数量、椎体高度丢失及恢复比例为隐性失血的危险因素。
Objective:To investigate the hidden blood loss and related risk factors of osteoporotic vertebral compression fractures after percutaneous kyphoplasty.Methods:The clinical data of 153 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty from March 2015 to December 2017 were retrospectively analyzed,including 55 males and 98 females,aged 68 to 87(78.6±11.4)years old.Erythrocyte specific volume was collected before and after operation to calculate the hidden blood loss.The influence of sex,age,body mass index,bone mineral density,diabetes mellitus and hypertension,operation mode(unilateral or bilateral),operation time,operative segment and number,loss height of vertebral body and recovery height ratio on hidden blood loss was analyzed by multiple linear regression model.Results:Postoperative hidden blood loss was(287.7±68.5)ml.Multivariate linear regression analysis showed that the history of diabetes mellitus(β=2.405,P=0.012),the mode of operation(β=3.042,P<0.001),the time of operation(β=2.043,P=0.038),the operative segment(β=1.993,P=0.043),the number(β=0.374,P<0.001),the loss of vertebral height(β=2.785,P=0.003)and the recovery ratio(β=7.301,P<0.01)were correlated with occult hemorrhage.Conclusion:There is a certain degree of occult hemorrhage in kyphoplasty for osteoporotic vertebral compression fractures.The risk factors of hidden hemorrhage are diabetes history,operation method,operation time,operative segment and number,loss of vertebral height and recovery ratio.
作者
管军辉
郑文标
黄皆和
王勇
杨晟
肖柏松
阮建伟
GUAN Jun-hui;ZHENG Wen-biao;HUANG Jie-he;WANG Yong;YANG Sheng;XIAO Bai-song;RUAN Jian-wei(Department of Orthopaedics,Taizhou Municipal Hospital,Taizhou 318000,Zhejiang,China)
出处
《中国骨伤》
CAS
CSCD
2019年第5期439-443,共5页
China Journal of Orthopaedics and Traumatology
基金
浙江省中医药科学研究基金项目(编号:2018ZB136)~~
作者简介
通讯作者:管军辉,E-mail:cheng90911@126.com
