骨质疏松性椎体压缩性骨折椎体后凸成形术后隐性失血及其影响因素分析 |
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投稿时间:2018-03-19 修订日期:2019-05-08
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期刊信息:《中国骨伤》年,第卷,第期,第-页 |
DOI: |
基金项目:浙江省中医药科学研究基金项目(2018ZB136) |
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中文摘要:【摘要】 目的:研究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:收集自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,其中男性55例,女性98例;年龄68~87(78.6±11.4)岁。收集患者术前术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(Beta=2.405,p=0.012)、手术方式(Beta=3.042,p<0.001)、手术时间(Beta=2.043,p=0.038)、手术节段(Beta=1.993,p=0.043)及数量(Beta=0.374,p<0.001)、椎体高度丢失(Beta=2.785,p=0.003)及恢复比例(Beta=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。 |
【关键词】骨质疏松,椎体压缩性骨折,椎体后凸成形术,隐性失血 |
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Hidden blood loss and risk factors following percutaneous kyphoplasty for osteoporotic vertebral compression fractures |
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ABSTRACT ABSTRACT Objective To quantity the hidden blood loss (HBL) and determine the risk factors following percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs). Methods A total of 153 patients with OVCFs who underwent bilateral or unilateral PKP from March 2015 to December 2017 were enrolled, including 55 males and 98 females, aged from 68 to 87 years old (78.6±11.4). The preoperative and postoperative hematocrit (Hct) were collected for calculating the HBL. Clinical data including gender, age, body mass index (BMI), bone mineral density (BMD), co-exiting morbidities (hypertension, diabetes mellitus), and approach, time, segment and quantity of the surgery, percentage of vertebral height loss and restoration were collected for analysis. Multivariate linear regression was used for determining the risk factors for HBL. Results The average of HBL was 287.7±68.5 mL. Multivariate linear regression indicated that diabetes mellitus (Beta=2.405,p=0.012), approach (Beta=3.042,p<0.001), time (Beta=2.043,p=0.038), segment (Beta=1.993,p=0.043) and quantity (Beta=0.374,p<0.001) of the surgery and percentage of vertebral height loss (Beta=2.785,p=0.003) and restoration (Beta=7.301,p<0.001) were correlated with HBL. Conclusions There was a considerable quantity of HBL following PKP for OVCFs, diabetes mellitus, approach, time, segment and quantity of the surgery and percentage of vertebral height loss and restoration were independent risk factors for HBL. |
KEY WORDS osteoporosis, vertebral compression fracture, percutaneous kyphoplasty, hidden blood loss |
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