人工半髋关节置换术后隐性失血的影响因素分析

Analysis of influencing factors for occult blood loss after artificial hip replacement

目的研究人工半髋关节置换术后隐性失血的影响因素。方法回顾性分析120例于重庆市北培区中医院进行人工半髋关节置换术后隐性失血的患者作为研究对象,以术后隐性失血量480 mL为分界线,将其分为高隐性失血组(31例,失血量≥480 mL),低隐性失血组(89例,失血量<480 mL),收集两组患者的临床资料,采用多因素Logistic回归分析影响隐性失血的因素。结果两组间年龄、糖尿病、高脂血症、骨质疏松的差异有统计学意义(P<0.05),其余对比差异均无统计学意义(P>0.05);多因素Logistic回归分析认为年龄60岁及以上(OR:8.953,95%CI:2.905,27.593)、骨质疏松(OR:5.127,95%CI:1.318,19.950)是人工半髋关节置换术后高隐性失血的危险因素。结论年龄60岁及以上和骨质疏松是人工半髋关节置换术术后高隐性失血的危险因素。因此,在临床实践中,对于年龄较大和存在骨质疏松的患者,应特别注意预防和监测术后隐性失血的发生,采取必要的措施来减少失血风险,促进患者的早日康复。

Objective To study the influencing factors for occult blood loss after artificial hip replacement.Methods A retrospective analysis was conducted on 120 patients who underwent artificial hip replacement with occult blood loss in the Chongqing Beibei District Traditional Chinese Medicine Hospital.Patients were assigned into the high occult blood loss group(31 cases,blood loss≥480 mL)and low occult blood loss group(89 cases,blood loss<480 mL)with the postoperative occult blood loss of 480 mL as the cut-off.Clinical data of the two groups of patients were collected,and multiple logistic regression analysis was used to identify the influencing factors for occult blood loss.Results There were significant differences in age,diabetes,hyperlipidemia and osteoporosis between the two groups(P<0.05),and there were no significant differences in other clinical data between groups(P>0.05).Multivariate Logistic regression analysis showed that age of 60 years and above(OR=8.953,95%CI 2.905,27.593)and osteoporosis(OR=5.127,95%CI 1.318,19.950)were risk factors for high occult blood loss after artificial hip replacement surgery.Conclusion Age of 60 years and above and osteoporosis are risk factors for high occult blood loss after artificial hip replacement.Therefore,in clinical practice,prevention and monitoring of postoperative occult blood loss especially in older patients and those with osteoporosis should be highlighted.Necessary measures are needed to reduce the risk of blood loss,and promote an early recovery.