中国组织工程研究2016，Vol.20Issue(37)：5489-5495,7.DOI:10.3969/j.issn.2095-4344.2016.37.003
老年股骨转子间骨折修复术前隐性失血与营养状况的关系
Correlation between preoperative hidden blood loss and nutritional status in elderly patients with intertrochanteric fracture
摘要
Abstract
BACKGROUND:The emergence of a large number of hidden blood loss during perioperative period of intertrochanteric fracture in the elderly not only increases the risk of perioperative period and complications, but also affects the postoperative recovery of joint function. At present, there is no relevant report about nutritional status and the hidden blood loss before surgery in and outside China. <br> OBJECTIVE:To identify the effect of nutritional status on preoperative hidden blood loss in elderly patients with intertrochanteric fracture. <br> METHODS:183 elderly patients with fresh and initial femoral intertrochanteric fracture were included. Laboratory serological examinations on admission and preoperation were completed. By mini nutritional assessment, patients were randomly divided into normal-nourishment group, malnourishment at risk group, and malnourishment group. The original blood volume and preoperative hidden blood loss were calculated depending on height, weight, hematocrit on admission and preoperation. According to the proportion of mean preoperative hidden blood loss on the original blood volume, patients were divided into low and high hidden blood loss groups. We compared preoperative hidden blood loss, and their proportion on the original blood volume and the preoperative incidence of high hidden blood loss, and analyzed the correlations between preoperative high hidden blood loss and preoperative nutritional status. <br> RESULTS AND CONCLUSION:(1) The nutritional status of elderly intertrochanteric fracture patients measured by mini nutritional assessment score was that the number of patients was 48 cases (26%) in normal-nourishment group, 64 cases (35%) in the malnourishment at risk group, and 71 cases (39%) in the malnourishment group. There were no obvious differences in the preoperative complications between any two groups (P>0.05). (2) Thirty-eight cases affected high hidden blood loss. The mean preoperative hidden blood loss was 260.43 mL. The proportion of preoperative hidden blood loss to the original blood volume was 6%. (3) The preoperative hidden blood loss, their proportion on the original blood volume and the incidence of high hidden blood loss were significantly higher in the malnourishment at risk group and malnourishment group than in the normal-nourishment group. Paired comparison showed significant differences (P<0.05). (4) Results confirmed that preoperative hidden blood loss, their proportion on the original blood volume and the incidence of high hidden blood loss gradual y increased with deterioration of nutritional status. The nutritional status is an important factor influencing the occurrence of preoperative hidden blood loss, and can be used as an important index for judging the high hidden blood loss and prognosis in elderly patients with intertrochanteric fracture.关键词
组织构建/骨组织工程/营养状况/老年人/股骨转子间骨折/隐性失血分类
医药卫生引用本文复制引用
刘国印,张勇,鲍磊,王进,徐院生,王梦茹,贾小宝,陈建民..老年股骨转子间骨折修复术前隐性失血与营养状况的关系[J].中国组织工程研究,2016,20(37):5489-5495,7.基金项目
南京市科技计划项目(201303039)；南京军区科技创新项目(MS055)Funding:the Science and Technology Project of Nanjing City, No.201303039 （201303039）
the Science and Technology Innovation Project of Nanjing Military Region, No. MS055 （）
