低蛋白血症延长髋膝关节置换患者住院日  

Preoperative hypoproteinemia increases length of stay in patients undergoing primary knee or hip arthroplasty

作　　者：徐兴全[1] 闫文强 姚尧[1] 严文津 郭虎 陈东阳[1] 徐志宏[1] 蒋青[1] 史冬泉[1] Xu Xingquan;Yan Wenqiang;Yao Yao;Yan Wenjin;Guo Hu;Chen Dongyang;Xu Zhihong;Jiang Qing;Shi Dongquan(Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属鼓楼医院运动医学与成人重建外科,210008

出　　处：《中华关节外科杂志（电子版）》2021年第1期39-44,共6页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：江苏省自然科学基金青年项目(BK20180127);国家自然科学基金青年项目(81802196)。

摘　　要：目的探讨术前低蛋白血症和初次髋膝关节置换术住院时长的相关性。方法回顾性分析2017年8月至2019年1月在南京鼓楼医院运动医学与成人重建外科行初次人工关节置换术的患者资料,排除掉资料不全、围手术期对并发症进行过针对治疗、一期行双侧关节置换、行翻修手术、血友病性关节炎等病人,共纳入男253例,女640例,年龄范围19~95岁。初次髋关节置换492例,初次膝关节置换401例。根据血清白蛋白数值将患者分为低蛋白血症组和正常组。分别记录两组患者总住院天数、术前住院天数及术后住院天数并进行比较。记录两组患者术前伴随基础疾病状态、围手术期输血情况以及术后并发症发生情况。两组患者间定量资料行Mann-Whitney U检验;性别、关节置换类型、伴随疾病及术后并发症之间采用卡方检验。采用多因素线性回归分析研究影响总住院时间的因素。并研究术前低蛋白血症和住院时长增加的相关性。结果入选人群中低蛋白血症发生率43.6%,两组人群在性别、年龄、关节置换种类方面差异均无统计学意义(P>0.05)。低蛋白血症组总住院时长、术前住院时长及术后住院时长均显著长于正常组[(11.5±4.0)d vs(10.5±3.9)d,U=78375,P<0.001;(5.1±2.6)d vs(4.8±2.4)d,U=88193,P=0.0093;(6.4±2.8)d vs(5.7±2.8)d,U=76023,P<0.001]。低蛋白血症组有更多比例的高血压病史、脑血栓病史以及手术史。两组患者在输血率及术后并发症方面差异均无统计学意义(均为P>0.05)。多元回归分析显示高龄、膝关节置换、脑血栓病史及低蛋白血症与住院时长显著相关。结论术前低蛋白血症可显著增加初次人工关节置换患者住院时长。Objective To evaluate the association between preoperative hypoalbuminemia and length of stay in patients undergoing primary knee or hip arthroplasty.Methods From August 2017 to January 2019,253 male and 640 female patients who underwent primary knee or hip arthroplasty were enrolled in this retrospective study.The patients with incomplete information,perioperative serious complications for specific treatment,bilateral arthroplasty,revision surgery,and hemophiliac arthritis were excluded.The age ranged from 19 to 95 years old.There were 492 cases of primary knee arthroplasty and 401 cases of primary hip arthroplasty.The patients were divided into the hypoproteinemia and normal group according to the serum albumin level.The lengths of total,preoperative and postoperative hospital stay of the two groups were recorded.The preoperative morbidities,perioperative blood transfusion rate,and postoperative complications in the two groups were recorded.The quantitative data between the two groups were evaluated by Mann-Whitney U test.The chi-square test was used to analyze the difference of gender,type of joint replacement,concomitantdiseases,and postoperative complications between the two groups.Multivariate linear regression was used to analyze the factors affecting the length of stay.The association between hypoproteinemia and increase of length of stay was analyzed.Results The total incidence of hypoproteinemia was 43.6%.There was no statistically significant difference in gender,age,or joint replacement type between the two groups(P>0.05).The total,preoperative,and postoperative lengths of stay in the hypoproteinemia group were significantly longer than those in the normal group[(11.5±4.0)d vs(10.5±3.9)d,U=78375,P<0.001;(5.1±2.6)d vs(4.8±2.4)d,U=88193,P<0.01;(6.4±2.8)d vs(5.7±2.8)d,U=76023,,P<0.001].The patients in hypoproteinemia group had a significantly higher proportion of hypertension,cerebral thrombosis and surgical history.There was no statistically significant difference in blood transfusion rate and pos

关 键 词：低蛋白血症 关节成形术 住院时间 

分 类 号：R47[医药卫生—护理学]