铁过载对老年骨质疏松性股骨转子间骨折术后谵妄的影响  

Effect of Iron Overload on Postoperative Delirium in Elderly Patients with Osteoporotic Femoral Intertrochanteric Fracture

作　　者：赵东阳[1] 崔巍[1] 徐志刚[1] 马春艳[1] 陶梨清 Zhao Dong-yang;Cui Wei;Xu Zhi-gang;Ma Chun-yan;Tao Li-qing(Department of Orthopaedics,Suzhou Xiangcheng People's Hospital,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]江苏省苏州市相城人民医院骨科,江苏苏州215000

出　　处：《中外医药研究》2022年第5期144-146,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨铁过载对老年股骨转子间骨折术后并发谵妄的影响。方法:选取2019年6月-2021年12月收治的老年骨质疏松性股骨转子间骨折并行手术治疗患者83例为观察对象,根据是否出现谵妄症状分为谵妄组12例与非谵妄组71例。分析两组患者血清铁蛋白(FER)、血清铁(FE)、不饱和铁结合力(UIBC)、血清转铁蛋白(TRF)、铁饱和度(TS)水平指标、临床指标以及术后6个月病死率,分析引起术后谵妄的危险因素。结果:谵妄组FER高于非谵妄组,差异有统计学意义(P<0.05),两组FE、UIBC、TRF、TS水平比较,差异无统计学意义(P>0.05);谵妄组患者年龄、视力或听力障碍、手术时间、手术失血量指标高于非谵妄组,差异有统计学意义(P<0.05);两组患者基础疾病、疼痛程度比较,差异无统计学意义(P>0.05);将有差异性观察因素列入Logistic回归模型,进行多因素回归分析,结果显示视力或听力障碍以及手术时间为患者发生术后谵妄的独立危险因素,差异有统计学意义(P<0.05);谵妄组术后6个月病死率高于非谵妄组,差异有统计学意义(P<0.05)。结论:FER可作为老年骨质疏松性股骨转子间骨折患者发生术后谵妄的一个监测指标,术后谵妄发生与多因素相关,存在较高死亡率。Objective:To investigate the effect of iron overload on postoperative concurrent delirium in elderly patients with femoral intertrochanteric fracture.Methods:From June 2019 to December 2021,83 elderly patients with osteoporotic femoral intertrochanteric fractures and receiving surgical treatment were selected as the observation subjects,and they were divided into delirium group(12 cases)and non-delirium group(71 cases)according to the presence/absence of delirium symptoms.The serum ferritin(FER),serum iron(FE),unsaturated iron-binding capacity(UIBC),serum transferrin(TRF),transferrin saturation(TS)level indicators,clinical indicators,and case fatality rate at postoperative 6 months in two groups were analyzed,and the risk factors causing postoperative delirium were analyzed.Results:The FER in the delirium group was higher than that in the non delirium group,and the difference was statistically significant(P<0.05),and there was no statistically significant difference in the levels of FE,UIBC,TRF and TS between two groups(P>0.05).The age,vision or hearing impairment,operation time,and intraoperative blood loss indicators of patients in the delirium group were higher than those in the non-delirium group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in underlying disease and pain degree between the two groups(P>0.05);The differential observational factors were included in the Logistic regression model and multivariate regression analysis was performed.The results showed that the vision or hearing impairment and operation time were the independent risk factors for the occurrence of postoperative delirium in patients,and the difference was statistically significant(P<0.05);The case fatality rate at 6 months after surgery in the delirium group was higher than that in the non-delirium group,and the difference was statistically significant(P<0.05).Conclusion:FER can be used as a monitoring index for postoperative delirium in elderly patients with osteoporotic fe

关 键 词：血清铁 谵妄 股骨转子间骨折 骨质疏松 

分 类 号：R47[医药卫生—护理学]