经皮椎体成形术治疗老年胸腰椎压缩骨折隐性失血的相关因素探讨

The related factors of hidden blood loss in elderly patients with thoracolumbar vertebral compression fractures treated by percutaneous vertebroplasty

目的探讨经皮椎体成形术(PVP)治疗老年胸腰椎压缩骨折隐性失血(HBL)的相关因素。方法选择接受PVP治疗的108例老年胸腰椎压缩骨折患者,其中男性41例,女性67例;年龄61~84岁,平均年龄74.2岁。收集患者性别、年龄、体质量、体质量指数(BMI)、骨密度等一般资料,记录患者手术节段、骨水泥渗漏情况、椎体压缩程度、椎体恢复程度等临床资料,多元线性回归分析PVP治疗老年胸腰椎压缩骨折HBL的相关因素。结果108例患者均成功完成手术,术后计算平均HBL为(319.8±56.5)mL,不同年龄、是否有高血压史、是否有糖尿病史、是否合并骨水泥渗漏、不同骨密度、椎体节段数、椎体压缩程度、椎体恢复程度患者HBL差异有统计学意义(P<0.05,P<0.01);多元线性回归分析显示椎体节段数、骨水泥渗漏、椎体压缩程度、椎体恢复程度是老年胸腰椎压缩骨折患者PVP手术时HBL的相关因素。结论HBL是老年胸腰椎压缩骨折患者PVP治疗不可忽视的客观存在,受伤椎体节段数、骨水泥渗漏、椎体压缩程度、椎体恢复程度是其发生的相关因素,术前应充分认识HBL危害性,并采取积极的应对措施确保患者的安全。

Objective To investigate the related factors of hidden blood loss(HBL)in elderly patients with thoracolumbar vertebral compression fractures treated by percutaneous vertebroplasty(PVP).Methods A total of 108 elderly patients with thoracolumbar compression fractures performed PVP treatment were enrolled,which included 41 males and 67 females,aged 61-84 years old with mean age of 74.2 years old.The patient general data of gender,age,body mass,body mass index(BMI)and bone mineral density were collected.The clinical data such as surgical segment,bone cement leakage,vertebral compression degree and vertebral recovery degree were recorded.The multiple linear regression analysis was used to probe the related factors of HBL in elderly patients with thoracolumbar vertebral compression fractures.Results All of 108 operations were successful.The mean HBL after operation was(319.8±56.5)mL.There were significant differences in HBL among patients with different age,history of hypertension,diabetes,bone cement leakage,bone mineral density,number of vertebral segments,vertebral compression degree and vertebral recovery degree(P<0.05,P<0.01).The multiple linear regression analysis showed that number of vertebral segments,bone cement leakage,vertebral compression degree and vertebral recovery degree were related factors of HBL in elderly patients with thoracolumbar vertebral compression fractures performed PVP.Conclusion It is demonstrated that the number of vertebral segments,bone cement leakage,vertebral compression degree and vertebral body recovery are related factors for PVP treatment.Risk of HBL in elderly patients with thoracolumbar compression fractures,which must take active and effective measures to ensure safety.