经皮椎体强化术围手术期隐性失血的相关因素分析  

Risk factors of hidden blood loss in percutaneous vertebral augmentation

作　　者：吴智华 莫凌[1,2] 程浣彤 梁德 崔健超[3] 唐晶晶[3] 任辉[3] 姚珍松[3] 江晓兵[3] WU Zhi-hua;MO Ling;CHENG Huan-tong;LIANG De;CUI Jian-chao;TANG Jing-jing;REN Hui;YAO Zhen-song;JIANG Xiao-bing(不详;Department of Spinal Surgery,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第三附属医院脊柱骨科,广东广州510240 [3]广州中医药大学第一附属医院脊柱骨科,广东广州510405

出　　处：《中国骨伤》2022年第8期732-735,共4页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金(编号:81774338)。

摘　　要：目的:探讨经皮椎体强化术治疗骨质疏松性椎体压缩骨折患者围手术期隐性失血的影响因素。方法:回顾性分析2018年10月至2019年12月行经皮椎体强化术的360例患者的临床资料,包括性别,年龄,手术方式,病程,身高,体重,手术节段,骨密度,骨水泥量,手术时间,椎体高度丢失率,椎体高度恢复率,骨水泥渗漏,凝血功能,术前及术后血红蛋白(hemoglobin,Hb),红细胞比容(hematocrit,HCT)和内科合并症等。根据Gross公式计算总失血量,采用t检验、多元线性回归和单因素方差分析不同因素对隐性失血的影响。结果:手术方式、手术节段、病程、骨水泥渗漏、术前Hb、椎基底静脉型渗漏和椎体节段静脉型渗漏与隐性失血显著相关(P<0.05)。结论:经皮椎体后凸成形术、双节段及多节段手术、病程≥6周、骨水泥椎基底静脉型渗漏和椎体节段静脉型渗漏,以及术前Hb越低的患者围手术期隐性失血越多。Objective:To explore the risk factors of hidden blood loss in osteoporosis vertebral compression fractures during percutaneous vertebral augmentation.Methods:From October 2018 to December 2019,360 patients with osteoporosis vertebral compression fractures who received percutaneous vertebral augmentation were enrolled in this study.The factors analyzed included gender,age,surgical methods,disease course,height,weight,the operative segment,bone mineral density,amount of bone cement,operative time,percentage of height loss,percentage of vertebral height restoration,cement leakage,blood clotting function,preoperative and postoperative hemoglobin and hematocrit and other internal diseases.Total blood loss was calculated by Gross’s formula,influential factors of the hidden blood loss were further analyzed by t-test,multivariate linear regression and one-way ANOVA analysis.Results:Surgical methods,the operative segment,disease course,cement leakage,preoperative hemoglobin,cement leakage via the basivertebral and segmental vein were significantly correlated with hidden blood loss(P<0.05).Conclusion:Patients with percutaneous kyphoplasty,two-level and multi-level surgery,the course of the disease beyond 6 weeks,cement leakage via the basivertebral and segmental vein,and lower preoperative hemoglobin had more perioperative hidden blood loss.

关 键 词：骨质疏松 脊柱骨折 经皮椎体强化术 隐性失血 相关因素分析 

分 类 号：R687.3[医药卫生—骨科学]