术前营养状况与老年骨质疏松性椎体压缩性骨折患者功能及术后预后的相关性

Correlation Between Preoperative Nutritional Status and Function and Postoperative Prognosis in Elderly Patients with Osteoporotic Vertebral Compression Fractures

目的探讨老年患者术前营养状况与骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCFs)患者功能及术后预后的相关性。方法选择2021-02/2022-02月在作者医院就诊的行经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗的老年OVCFs患者149例为研究对象。患者均于入院24 h内进行微型营养评估(mini nutritional assessment,MNA),根据营养状况分为营养良好组(n=35)、营养风险组(n=74)和营养不良组(n=40)。对OVCFs患者骨密度(bone mineral density,BMD)进行检测,于术前、术后3个月、术后6个月对OVCFs患者进行视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数以及椎体高度压缩率、Cobb角变化进行评估。结果3组OVCFs患者手术时间、术中出血量和骨水泥注入量组间比较差异均无统计学意义(P>0.05)。术后3、6个月OVCFs患者VAS评分、Oswestry功能障碍指数、椎体高度压缩率以及Cobb角显著降低(P均<0.05),且营养良好组OVCFs患者VAS评分、Oswestry功能障碍指数、椎体高度压缩率以及Cobb角改善情况显著优于营养风险组及营养不良组(P均<0.05),且营养风险组OVCFs患者VAS评分、Oswestry功能障碍指数、椎体高度压缩率以及Cobb角改善情况显著优于营养不良组(P均<0.05)。相关性分析显示,OVCFs患者MNA营养状况与术后3、6个月VAS评分、Oswestry功能障碍指数、椎体高度压缩率、Cobb角均呈显著负相关关系(P<0.05)。结论OVCFs患者营养状况与患者PKP术后功能恢复以及术后预后密切相关,营养状况越差则术后预后情况越差,需积极关注患者营养状况,从而促进患者术后康复。

Objective To explore the correlation between preoperative nutritional status of elderly patients and function and postoperative prognosis in elderly patients with osteoporotic vertebral compression fractures(OVCFs).Methods A total of 149 elderly OVCFs patients who underwent percutaneous kyphoplasty(PKP)treatment at the au-thor's hospital from February 2021 to February 2022 were selected as the study subjects.The patients were divided into well nourished group(n=35),nutritional risk group(n=74)and malnutrition group(n=40)according to mini nu-tritional assessment(MNA)within 24 hours after admission;the bone mineral density(BMD)of the OVCFs patients was detected,and the changes in visual analogue scale(VAS),Oswestry dysfunction index,vertebral height compres-sion rate and Cobb angle of OVCFs patients before surgery and 3,6 months after surgery were evaluated.Results There were no significant differences in surgery time,intraoperative blood loss and bone cement injection volume of OVCFs patients among the three groups(P>0.05).The VAS score,Oswestry dysfunction index,vertebral height com-pression rate and Cobb angle of OVCFs patients significantly decreased at 3 and 6 months after surgery(all P<0.05),the VAS score,Oswestry dysfunction index,vertebral height compression rate and Cobb angle of OVCFs patients in the well nour-ished group were significantly better than those in the nutrition risk group and malnutrition group(all P<0.05),and the VAS score,Oswestry dysfunction index,vertebral height compression rate and Cobb angle of OVCFs patients in the nutrition risk group were significantly better than those in the malnutrition group(all P<0.05).Correlation analysis showed that there was a significant negative correlation between the MNA nutritional status and postoperative VAS score,Oswestry dysfunction in-dex,vertebral height compression rate and Cobb angle of OVCFs patients at 3 and 6 months after surgery(P<0.05).Conclusion The nutritional status of OVCFs patients is closely related to their postoperative function recovery and prognosis after PKP surgery,the worse the nutritional status,the worse the postoperative prognosis.It is necessary to actively monitor the nutritional status of patients to promote their postoperative re-covery.