老年骨质疏松合并终末期肾病髋部骨折患者的临床特点及管理

Clinical characteristics and management of hip fractures in elderly patients with dialysis-dependent end-stage renal diseases

目的分析老年骨质疏松合并终末期肾病髋部骨折患者的临床特点及管理,探讨患者手术治疗的可行性及围手术期管理策略。方法选择2013年1月至2016年1月北京中日友好医院创伤骨科手术治疗的34例依赖透析的老年髋部骨折患者,回顾性研究患者的一般资料,与对照组比较血红蛋白、白蛋白、血压、血钾、骨密度等,探讨围手术期的管理策略。结果与对照组相比,透析组患者术前血压、血红蛋白、白蛋白、血钾、骨密度差异均具有统计学意义(P<0.05)。结论终末期肾病依赖透析的老年患者行髋部骨折手术时风险极高,但通过合理安排透析计划及其他辅助支持治疗,可平稳度过围手术期,并取得较好的预后效果。

Objective To analyze the clinical characteristics and prognosis of elderly hip fracture patients complicated with endstage renal disease,and to investigate the feasibility of surgery and perioperative management strategy of the patients. Methods Study subjects were 34 elderly dialysis patients with hip fracture treated at the Trauma Orthopaedics Department of China-Japan FriendshipHospital from 2013-2016,data retrospectively collected including patients＇ general information,blood pressure,hemoglobin,albumin,K ＋,BMD and complication. Perioperative management strategies were explored. Results Compared with the control group,the preoperative blood pressure,hemoglobin,albumin,electrolyte and BMD of the dialysis group were significantly different（P〈0. 05）. Conclusion Dialysis-dependent patients with end-stage renal diseases are a high risk group receiving hip fracture surgery,but after reasonable arrangement of dialysis program and other support treatment,the orthopaedic operation can be tolerated safely and improve the life quality of patients with good prognosis.