椎体后凸成形术后隐性失血的危险因素分析

Risk Factors Research for Hidden Blood Loss after Percutaneous Kyphoplasty

目的研究椎体后凸成形术(percutaneous kyphoplasty,PKP)隐性失血量及其相关影响因素。方法回顾自2012年6月至2016年6月于我院接受PKP治疗的124例胸腰椎骨质疏松压缩骨折患者的临床资料,计算隐性失血量;分析性别、年龄、身体质量指数、椎体压缩程度、椎体恢复程度、手术椎体数量、骨密度、骨水泥渗漏、内科疾病(糖尿病、高血压)等因素对隐性失血的影响。结果椎体后凸成形术后隐性失血量(304±171)mL。椎体压缩程度、椎体恢复程度、手术椎体数量、骨密度、骨水泥渗漏与隐性失血量有相关性(P<0.05)。性别、年龄、身体质量指数、糖尿病、高血压与隐性失血量无相关性(P>0.05)。结论椎体后凸成形术隐性失血不可忽视,尤其是多发伤和老年身体代偿能力差的患者,术前应正确认识隐性失血,确保患者围手术期安全。

Objective To examine the amount of hidden blood loss and determine its relative influential factors after percutaneous kyphoplasty.Methods We retrospectively analyzed 124patients of thoracolumbar vertebral compression fracturetreated withPKP from June 2012 to June2016 inLiaoyang CentralHospital.The amount of hidden blood loss was Calculated.The influential factors on hidden blood loss analyzed included gender,age,body mass index,the degree of vertebral compression,the degree of vertebral body restoration,number of treated fracture levels,bone mineral density,bone cement leakage and internal diseases （diabetes,hypertension）.Results The mean amount of hidden blood loss was （304＆#177;171）mL.The degree of vertebral compression,the degree of vertebral body restoration,number of treated fracture levels,bone mineral density,bone cement leakage were significantly associated with the amount of hidden blood loss （P〈0.05）.Gender,age,body mass index,diabetes,hypertension were not significantly associated with the amount of hidden blood loss（P〉0.05）.Conclusion Hidden blood loss cannot be ignored,especially for multiple injuries patients and the elderly with poor physical condition.Having a correct understanding of hidden blood loss can help ensure patients＇ safety in perioperative period.