老年腰椎管狭窄症术后隐性失血危险因素分析  

Analysis of risk factors of postoperative hidden blood loss in elderly patients with lumbar spinal stenosis

作　　者：王利[1] 许步伟[1] 孙焕建[1] WANG Li;XU Buwei;SUN Huanjian(Department of Orthopedics,the Third People's Hospital of Yancheng,Yancheng 224001,China)

机构地区：[1]盐城市第三人民医院骨科,江苏盐城224001

出　　处：《长春中医药大学学报》2023年第10期1156-1159,共4页Journal of Changchun University of Chinese Medicine

基　　金：江苏省卫生健康委员会科研项目(H2019088)。

摘　　要：目的分析老年腰椎管狭窄症后路手术后隐性失血的危险因素。方法选择2019年4月-2022年3月就诊的83例老年腰椎管狭窄症患者为研究对象,患者均经后路行腰椎椎体间融合术,根据患者术后隐性失血量的高低分为低隐性失血组(失血量<480 mL)与高隐性失血组(失血量≥480 mL),采用Logistic多因素回归分析老年腰椎管狭窄症后路手术后隐性失血量高的影响因素。结果低隐性失血组38例,高隐性失血组45例。高隐性失血组年龄、血红蛋白下降量、手术时间>80 min、高血压、使用抗凝药物、非贫血、椎间盘退变分级为4级例数占比高于低隐性失血组(P<0.05)。Logistic多因素回归分析结果显示,年龄、血红蛋白下降量、高血压、椎间盘退变分级4级为老年腰椎管狭窄症后路手术后隐性失血量高的影响因素(P<0.05)。结论年龄较高、血红蛋白下降量较大、椎间盘退变分级较高、合并高血压的老年腰椎管狭窄症后路手术后隐性失血量的风险较大。Objective To analyze the risk factors of hidden blood loss after posterior surgery in elderly patients with lumbar spinal stenosis.Methods A total of 83 elderly patients with lumbar spinal stenosis admitted to Department of Orthopedics of the Third People's Hospital of Yancheng from April 2019 to March 2022 were selected as research objects.All patients underwent posterior lumbar interbody fusion and were divided into the low hidden blood loss group(<480 mL)and the high hidden blood loss group(≥480 mL)according to postoperative hidden blood loss.Logistic multivariate regression analysis was used to analyze the influencing factors of high hidden blood loss after posterior surgery in elderly patients with lumbar spinal stenosis.Results There were 38 cases in the low hidden blood loss group and 45 cases in the high hidden blood loss group.In the high hidden blood loss group,the age was older than that in the low hidden blood loss group,and the level of hemoglobin decreased was higher than that in the low hidden blood loss group.The proportion of patients with surgery time>80min,hypertension,anticoagulant use,non anemia and intervertebral disc degeneration grading as grade 4 in the high hidden blood loss group was higher than that in the low hidden blood loss group(P<0.05).Logistic multivariate regression analysis showed that age,the level of hemoglobin decreased,hypertension and intervertebral disc degeneration grading as grade 4 were the influential factors for high hidden blood loss after posterior surgery for elderly lumbar spinal stenosis(P<0.05).Conclusion Elderly patients with lumbar spinal stenosis with older age,significant decrease in hemoglobin,higher grade of intervertebral disc degeneration and combined hypertension have the higher risk of hidden blood loss after posterior surgery.

关 键 词：老年 腰椎管狭窄症 后路手术 隐性失血 危险因素 

分 类 号：R681[医药卫生—骨科学]