>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
老年髋部骨折患者术前低蛋白血症发生情况分析
作者:石利涛  赵景新 
单位:承德医学院附属医院 创伤骨科, 河北 承德 067000
关键词:髋部骨折 股骨颈骨折 股骨转子间骨折 低蛋白血症 
分类号:R683.42
出版年·卷·期(页码):2020·39·第六期(821-825)
摘要:

目的:分析老年髋部骨折患者术前低蛋白血症发生情况,以指导对患者术前低蛋白血症的诊治。方法:收集476例老年髋部骨折患者(骨折组)的临床资料及304例体检老年人(对照组)的相应资料,比较两组研究对象基线资料、年龄分布、合并疾病、低蛋白血症发生率及严重程度的差异,并比较转子间骨折与股骨颈骨折患者低蛋白血症发生率及严重程度的差异。结果:骨折组脑血管疾病患病率高于对照组(P<0.001),两组基线资料及合并其它疾病情况差异无统计学意义(P>0.05)。骨折组与对照组低蛋白血症发生率分别为30.67%与4.93%,差异有统计学意义(P<0.05)。骨折组与对照组60~69岁、70~79岁、≥80岁年龄段低蛋白血症发生率分别为18.92%、31.18%、37.43%与5.08%、5.10%、4.55%,两组分年龄段比较差异均有统计学意义(均P<0.05)。骨折组低蛋白血症严重程度高于对照组(P<0.05)。转子间骨折患者低蛋白血症发生率(37.98%)及严重程度均高于股骨颈骨折患者的发生率(22.02%)及严重程度(均P<0.05)。结论:老年髋部骨折患者术前低蛋白血症发生率高,以轻、中度低蛋白血症为主,并有随着年龄增长而升高的趋势,转子间骨折较股骨颈骨折患者低蛋白血症发生率高、程度重。对老年髋部骨折患者尤其是高龄的转子间骨折患者,入院后需及时明确有无低蛋白血症,以及时纠正。

Objective: To investigate the incidence of preoperative hypoproteinemia in elderly patients with hip fracture to better guide its treatment. Methods: Clinical data of 476 elderly patients with hip fracture(the fracture group) and 304 elderlies undergoing physical examination(the control group) were analyzed. The differences in basic health conditions, comorbid diseases, age distribution and the incidence and severity of hypoproteinemia were compared between two groups. Differences in the incidence and severity of hypoproteinemia between patients with intertrochanteric fracture and patients with femoral neck fracture were also compared. Results: The incidence of cerebrovascular diseases in fracture group patients was significantly higher than that in the control group. There was no significant difference between two groups in basic health conditions and other diseases. The incidence of hypoproteinemia was 30.67% in the fracture group and 4.93% in the control group, with significant difference. The incidences of hypoproteinemia in the fracture group and the control group were 18.92%, 31.18%, 37.43% and 5.08%, 5.10%, 4.55% in 60-69, 70-79 and ≥ 80 years old, respectively, all with significant differences. The severity of hypoproteinemia in the fracture group was greater than that in the control group. The incidences of hypoproteinemia in patients with intertrochanteric fracture and femoral neck fracture were 37.98% and 22.02%, with significant differences. The severity of hypoproteinemia in patients with intertrochanteric fracture was greater than that in patients with femoral neck fracture. Conclusion: Preoperative hypoproteinemia occurs frequently in elderly patients with hip fractures, with most cases being mild or medium hypoproteinemia, and the incidence tends to increase with age. Both the incidence and severity of hypoproteinemia in patients with intertrochanteric fracture are higher than those in patients with femoral neck fracture. It is recommended that elderly patients with hip fractures, especially those with intertrochanteric fractures, test for hypoproteinemia after admission to the hospital for treatment in time.

参考文献:

[1] 梁玉柱,郭洪刚.老年骨质疏松性髋部骨折:昨天、今天及未来[J].中国组织工程研究,2017,21(15):2438-2443.
[2] 付勤.老年髋部脆性骨折的治疗现状及关注热点[J].中国骨质疏松和骨矿盐疾病杂志,2017,10(1):7-11.
[3] TOSOUNIDIS T H,CASTILLO R,KANAKARIS N K,et al.Common complications in hip fracture surgery:Tips/tricks and solutions to avoid them[J].Injury,2015,46(Suppl 5):S3-S11.
[4] 徐芙蓉,叶洁玉,董飞.健康教育路径对老年骨质疏松性髋部骨折患者的应用效果研究[J].现代医学,2019,47(6):731-734.
[5] 张琛海,邓桂彬,钟诚凡,等.入院水合状态对老年髋部骨折围手术期急性并发症的影响[J].现代医学,2020,48(5):627-630.
[6] PRODOVIC T,RISTIC B,RANCIC N,et al.Factors influencing the six-month mortality rate in patients with a hip fracture[J].Zdr Varst,2016,55(2):102-107.
[7] GATTA A,VERARDO A,BOLOGNESI M.Hypoalbuminemia[J].Intern Emerg Med,2012,7(Suppl 3):S193-S199.
[8] WONG J S,BROOKS D,INNESS E L,et al.The impact of falls on motor and cognitive recovery after discharge from in-patient stroke rehabilitation[J].J Stroke Cerebrovasc Dis,2016,25(7):1613-1621.
[9] SMITH É,COMISKEY C,CARROLL Á.Prevalence of and risk factors for osteoporosis in adults with acquired brain injury[J].Ir J Med Sci,2016,185(2):473-481.
[10] MARZOLINI S,MCLLROY W,TANG A,et al.Predictors of low bone mineral density of the stroke-affected hip among ambulatory individuals with chronic stroke[J].Osteoporos Int,2014,25(11):2631-2638.
[11] 金占萍,朱迎春,王哲洋,等.老年髋部骨折手术患者围手术期营养风险与营养摄入现况调查[J].中华现代护理杂志,2016,22(36):5240-5242.
[12] YU W,ZHANG X,WU R,et al.The visible and hidden blood loss of Asia proximal femoral nail anti-rotation and dynamic hip screw in the treatment of intertrochanteric fractures of elderly high-risk patients:a retrospective comparative study with a minimum 3 years of follow-up[J].BMC Musculoskelet Disord,2016,11(17):269.
[13] AFSHINNIA F,PENNATHUR S.Association of hypoalbuminemia with osteoporosis:analysis of the national health and nutrition examination survey[J].J Clin Endocrinol Metab,2016,101(6):2468-2474.
[14] BONJOUR J P.The dietary protein,IGF-I,skeletal health axis[J].Horm Mol Biol Clin Investig,2016,28(1):39-53.
[15] AFSHINNIA F,WONG K K,SUNDARAM B,et al.Hypoalbuminemia and osteoporosis:reappraisal of a controversy[J].J Clin Endocrinol Metab,2016,101(1):167-175.
[16] GOISSER S,SCHRADER E,SINGLER K,et al.Malnutrition according to mini nutritional assessment is associated with severe functional impairment in geriatric patients before and up to 6 months after hip fracture[J].J Am Med Dir Assoc,2015,16(8):661-667.
[17] CAO X,LIN W,LIANG C,et al.Naringin rescued the TNF-α-induced inhibition of osteogenesis of bone marrow-derived mesenchymal stem cells by depressing the activation of NF-κB signaling pathway[J].Immunol Res,2015,62(3):357-367.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 420615 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364