经皮椎弓根螺钉治疗胸腰椎骨折术后隐性失血量的影响因素分析  

Analysis on the factors affecting hidden blood loss volume in patients following treatment of thoracolumbar fractures with percutaneous pedicle screws

作　　者：李毅 詹文豪 汪颖峰[1] 韩建邦[1] 黄定安[1] LI Yi;ZHAN Wenhao;WANG Yinfen;HAN Jianbang;HUANG Dingan(Department of Spine Orthopedics,Huangshan City People′s Hospital,Huangshan 245000,China)

机构地区：[1]黄山市人民医院脊柱外科,安徽黄山245000

出　　处：《皖南医学院学报》2023年第6期561-564,共4页Journal of Wannan Medical College

基　　金：黄山市科技计划项目(2020KN-13)。

摘　　要：目的:研究经皮椎弓根螺钉治疗胸腰椎骨折术后隐性失血量(HBL)及相关影响因素。方法:选取2018年7月~2022年7月黄山市人民医院脊柱外科收治的胸腰椎骨折并行经皮椎弓根螺钉治疗的50例患者为研究对象,其中男28例,女22例,平均年龄(53.92±9.44)岁。其中T 11骨折3例、T 12骨折5例、L 1骨折23例、L 2骨折9例、L 3骨折7例、L 4骨折3例。记录患者身高、年龄、体质量、受伤至手术时间、内科合并症以及术前1 d和术后3 d患者红细胞比容(HCT),通过分组对比以及多元线性回归分析不同情况下HBL的大小及影响因素。结果:下腰椎骨折术后HBL[(480.86±192.83)mL]高于胸腰段骨折HBL[(304.97±172.32)mL](P<0.05)。受伤至手术时间与患者隐性失血量呈负相关(P<0.05);而患者总失血量(TBL)与HBL呈正相关(P<0.01);多元线性回归分析显示,患者TBL越多手术HBL就越多(P<0.05)。结论:经皮椎弓根螺钉治疗胸腰椎骨折时,下腰椎HBL高于胸腰段;患者的TBL越多术后HBL就越多。Objective:To investigate the amount of hidden blood loss in patients of thoracolumbar fractures after treatment with percutaneous pedicle screws and related factors affecting the blood loss volume.Methods:Fifty patients(28 males,and 22 females)of thoracolumbar spine fracture treated with percutaneous pedicle screws in our department were included from July 2018 to July 2022.The average age was(53.92±9.44)years for the patients.Fractures occurred at T 11 in 3 cases,at T 12 in 5,at L 1 in 23,at L 2 in 9,at L 3 in 7 and at L 4 in 3.The data,including patients′height and age,body weight,time from injury to surgery,medical comorbidities and erythrocyte hematocrit(HCT)the day before surgery and three days after operation,were recorded.Then the cases were grouped and compared for the factors affecting the amount of HBL under different conditions using multivariate linear regression model.Results:Postoperative hidden blood loss was higher in lower lumbar fractures than in thoracolumbar segment fractures[(480.86±192.83)mL vs.(304.97±172.32)mL,P<0.05].The time from injury to surgery was negatively correlated with the patient′s hidden blood loss(P<0.05),whereas the total blood loss(TBL)was positively correlated with the hidden blood loss in the patients(P<0.01).Multivariate linear regression analysis showed that the more the patient′s overall blood loss was,the more the surgical hidden blood loss would be(P<0.05).Conclusion:Hidden bleeding was higher in the lower lumbar spine than in the thoracolumbar segment when percutaneous pedicle screws used to treat thoracolumbar fractures,and more hidden blood loss is associated with higher total blood loss.

关 键 词：经皮椎弓根螺钉 胸腰椎骨折 隐性失血量 

分 类 号：R687.3[医药卫生—骨科学]