肌少症对老年股骨粗隆间骨折女性患者围术期输血情况的影响  

Effect of sarcopenia on perioperative blood transfusion in elderly female patients with femoral intertrochanteric fracture

作　　者：李娜[1] 张凯[1] LI Na;ZHANG Kai(Department of Blood Transfusion,Tianjin Hospital,Tianjin(300021),China)

机构地区：[1]天津市天津医院(天津大学天津医院)输血科,天津300021

出　　处：《中国中西医结合外科杂志》2023年第1期52-54,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨肌少症是否影响老年粗隆间骨折女性患者行股骨近端防旋髓内钉(PFNA)手术时的输血情况。方法:选取天津市天津医院收治的88例股骨粗隆间骨折接受PFNA手术治疗的老年女性患者,采用胸12椎体(T12)水平的骨骼肌指数截断值30.6 cm2/m2诊断肌少症。本组88例患者中,肌少症组31例,非肌少症组57例。比较肌少症与非肌少症组患者一般资料及住院时间、输血量、输血率、术后1 d血红蛋白量、术后1年患者死亡率等资料。结果:肌少症组术后1d的血红蛋白量为(82.78±22.73)g/L,低于非肌少症组(98.89±24.79)g/L,差异有统计学意义(P<0.05);肌少症组的输血率(25.81%)及围术期输血量(1.51±0.93)U均显著大于非肌少症组(P<0.05);肌少症组的住院时间(13.31±5.13)d及术后1年内死亡率(32.26%)均高于非肌少症组(P<0.05)。结论:肌少症可导致老年股骨粗隆间骨折女性患者行PFNA手术的围术期输血量及输血率显著增加,并导致患者的住院时间及术后1年死亡率明显增加。肌少症对评估老年股骨粗隆间骨折的围术期输血风险及预后具有一定的应用价值。Objective To investigate whether sarcopenia has significant effects on the blood transfusion of elderly female patients with intertrochanteric fracture undergoing PFNA operation.Methods Eighty eight elderly female patients with femoral intertrochanteric fracture treated with PFNA in Tianjin hospital were selected.The cut-off value of skeletal muscle index at T12 level of 30.6 cm~2/m~2 was used to diagnose sarcopenia.88patients in this group,31 were in the sarcopenia group and 57 were in non-sarcopenia group.The general clinical characteristics,hospitalization time,blood transfusion volume,blood transfusion rate,hemoglobin volume on the first day after operation and mortality of patients one year after operation were compared between two groups.Results The hemoglobin level of sarcopenia group(82.78±22.73)g/L was lower than that of non-sarcopenia group(98.89±24.79)g/L,and the difference was statistically significant(P<0.05);the transfusion rate(25.81%)and perioperative transfusion volume(1.51±0.93)units in sarcopenia group were significantly higher than those in non-sarcopenia group(P<0.05);at the same time,the length of hospital stay(13.31±5.13)days and oneyear mortality after surgery(32.26%)in the sarcopenia group were higher than those in the non-sarcopenia group(P<0.05).Conclusion Sarcopenia could significantly increase the amount and rate of perioperative blood transfusion in elderly female patients with femoral intertrochanteric fracture undergoing PFNA,and significantly increase the length of hospital stay and 1-year postoperative mortality after surgery.Sarcopenia has certain application value in evaluating the perioperative blood transfusion risk and prognosis of femoral intertrochanteric fracture in the elderly.

关 键 词：肌少症 老年女性 股骨粗隆间骨折 股骨近端防旋髓内钉 输血 

分 类 号：R683[医药卫生—骨科学]