老年髋部骨折患者术前低蛋白血症发生情况分析-东南大学学报医学版

老年髋部骨折患者术前低蛋白血症发生情况分析

单位：承德医学院附属医院创伤骨科, 河北承德 067000

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.

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