术前糖化血红蛋白水平对合并2型糖尿病的老年髋部骨折病人预后的影响  

The influence of preoperative HbA1c level on the clinical prognosis of elderly patients with hip fracture complicated with type 2 diabetes

作　　者：彭博成 李宗焕[1] 漆白文[1] 肖卫东[1] 简超[1] 喻爱喜[1] PENG Bocheng;LI Zonghuan;QI Baiwen(Department of Trauma and Micro-orthopedics,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院创伤与显微骨科,430071

出　　处：《临床外科杂志》2021年第2期165-168,共4页Journal of Clinical Surgery

摘　　要：目的探讨术前糖化血红蛋白(hemoglobin A1c, HbA1c)水平对合并2型糖尿病(type 2 diabetes mellitus, T2DM)的老年髋部骨折病人预后的影响。方法 2014年1月~2019年10月我院行手术治疗的合并2型糖尿病老年髋部骨折病人97例,根据术前HbA1c水平将其分为A组(HbA1c<6.5%,47例)和B组(HbA1c≥6.5%,50例),比较两组病人术后疼痛VAS评分、术后髋关节功能Harris评分、术后并发症发生率、手术时间、住院时间、拆线时间和转子间骨折愈合时间。结果 B组术后2天,7天,14天VAS评分、术后并发症发生率、住院时间、拆线时间、转子间骨折完全愈合时间优于A组,术后1、3、6个月Harris评分低于A组,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。结论合并2型糖尿病的老年髋部骨折病人,术前高水平的HbA1c可能提示预后不佳,关注术前HbA1c水平并采取相关措施有利于促进髋关节功能恢复以及降低术后并发症的发生率。Objective To investigate the effect of preoperative hemoglobin A1 c(HbA1 c) level on the clinical prognosis of hip fracture in elderly patients with type 2 diabetes mellitus.Methods The clinical data of 97 elderly patients with hip fracture complicated with type 2 diabetes mellitus who underwent surgery in our hospital from January 2014 to October 2019 were retrospectively analyzed.They were divided into group A(HbA1 c<6.5%,n=47) and group B(HbA1 c≥6.5%,n=50) according to their preoperative HbA1 c level, VAS score of pain at 2,7 and 14 days after operation, Harris score of postoperative hip joint function, incidence of postoperative complications, operation time, hospital stay, suture removal time and intertrochanteric fracture healing time were analyzed and compared between the two groups.Results The VAS score of pain at 2,7 and 14 days after operation, postoperative complication rate, hospitalization time, suture removal time and complete intertrochanteric fracture healing time in group B were significantly higher than those in group A after operation, while the Harris scores at 1,3 and 6 months after operation in group B were significantly lower than those in group A(P<0.05),but there was no significant difference in operation time between the two groups(P>0.05).Conclusion For the elderly hip fracture patients with type 2 diabetes mellitus, the preoperative high level of HbA1 c may indicate a poor clinical prognosis.Paying attention to the preoperative HbA1 c level and taking relevant measures can promote the recovery of hip joint function, reduce the incidence of postoperative complications.

关 键 词：髋部骨折 2型糖尿病 糖化血红蛋白 老年 手术 预后 

分 类 号：R587.2[医药卫生—内分泌] R687.3[医药卫生—内科学]