原发性高血压患者全膝关节置换术后低钾血症发生的多因素分析  

Multivariate Analysis of Hypokalemia in Patients With Primary Hypertension After Total Knee Arthroplasty

作　　者：来璇[1] 张华[2] 王海军[3] 韩永正[4] 姜玲[1] Lai Xuan;Zhang Hua;Wang Haijun(Department of Geriatrics,Peking University Third Hospital,Beijing 100191,China;不详)

机构地区：[1]北京大学第三医院老年内科,北京100191 [2]北京大学第三医院临床流行病研究中心,北京100191 [3]北京大学第三医院运动医学研究所,北京100191 [4]北京大学第三医院麻醉科,北京100191

出　　处：《中国微创外科杂志》2021年第5期399-404,共6页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨原发性高血压患者全膝关节置换术(total knee arthroplasty,TKA)后低钾血症的影响因素。方法回顾性分析我院运动医学研究所2016年1月~10月169例原发性高血压接受TKA的临床资料,依据术后血钾水平分为术后低血钾组(n=56)和术后正常血钾组(n=113),单因素分析筛选有统计学差异的变量进行多因素logistic回归分析。结果单因素分析显示钙通道阻滞剂(calcium channel block,CCB)、术中出血量、围手术期镇痛、术前估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、术前血尿素氮、术前血钾2组间差异有显著性(P<0.05)。多因素logistic回归提示术前血钾(OR=0.005,P=0.000)、围手术期股神经阻滞(femoral nerve block,FNB)镇痛(OR=0.139,P=0.001)为术后低钾血症发生的保护因素,CCB为术后低钾血症发生的危险因素(OR=3.570,P=0.011)。结论术前血钾水平高、围手术期FNB镇痛能降低原发性高血压患者TKA术后发生低钾血症的风险,口服CCB类降压药物增加术后发生低钾血症的风险。Objective To explore the influencing factors of hypokalemia in patients with primary hypertension after total knee arthroplasty(TKA).Methods Clinical data of 169 patients with primary hypertension who underwent TKA in our hospital from January to October 2016 were retrospectively analyzed.According to postoperative serum potassium,the patients were divided into hypokalemia group(n=56)and normal kalemia group(n=113).Univariate analysis was used to screen the variables with statistical difference.Multivariate logistic regression analysis was used to analyze the factors related to postoperative hypokalemia.ResultsUnivariate analysis showed that there were significant differences in calcium channel block(CCB),intraoperative blood loss,perioperative analgesia,preoperative estimated glomerular filtration rate(eGFR),preoperative urea nitrogen,preoperative serum potassium between the two groups(P<0.05).Multivariate logistic regression showed that preoperative serum potassium(OR=0.005,P=0.000)and femoral nerve block(FNB)(OR=0.139,P=0.001)were the protective factors of postoperative hypokalemia,and CCB(OR=3.570,P=0.011)was the risk factor of postoperative hypokalemia.Conclusion The preoperative high level of serum potassium and FNB reduce the risk of hypokalemia in patients with primary hypertension after TKA,while CCB increases the risk of postoperative hypokalemia.

关 键 词：原发性高血压 全膝关节置换术 低钾血症 影响因素 

分 类 号：R544.1[医药卫生—心血管疾病] R687.4[医药卫生—内科学]