Cai Tongchuan, Wang Feng, Nan Liping, Chen Dong, Wang Shuguang, Feng Xinmin, Zhang Wenjie, Zhang Liang
Department of Orthopedics, Dalian Medical University, Dalian, China.
Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou, China.
Geriatr Orthop Surg Rehabil. 2021 Feb 23;12:2151459321996178. doi: 10.1177/2151459321996178. eCollection 2021.
To analyze perioperative hidden blood loss (HBL) and its influencing factors in elderly patients with osteoporotic vertebral compression fracture (OVCF) treated with percutaneous vertebroplasty (PVP).
From January 2016 to December 2018, 103 elderly patients with OVCF (age > 85 years) treated with PVP were selected. The patient's height, weight, duration of symptoms, previous medical history and other basic information were recorded. The hemoglobin (Hb) and hematocrit (Hct) immediately after admission and the next day postoperative were recorded. The operation time, surgical bleeding, Kummell's disease, vertebral height preoperative and postoperative, and bone cement leakage was recorded. The total blood loss (TBL) was calculated according to Gross's formula, and HBL was calculated based on the TBL and surgical bleeding. The influential factors were analyzed by multivariate linear regression analysis and single factor correlation analysis.
The mean surgical bleeding was 11.83 ± 5.37 mL, and HBL was 306.19 ± 185.92 mL, with a statistically significant difference (P = 0.000). According to the multiple linear regression analysis, the duration of symptoms (P = 0.030), number of fracture segments (P = 0.016), operation time (P = 0.004), loss of vertebral height (P = 0.026), recovery of vertebral height (P = 0.004), Kummell's disease (P = 0.040) and cement leakage (P = 0.004) were correlated with an increased amount of HBL. Sex (P = 0.077), body mass index (BMI) (P = 0.486), hypertension (P = 0.734), diabetes (P = 0.769), fracture level (P = 0.518) and surgical bleeding (P = 0.821) had no correlation with the amount of HBL.
There was obvious HBL during the perioperative period of PVP in elderly patients with OVCF. A fresh fracture, multi-segment vertebral fracture, longer operation time, presence of Kummell's disease, loss of vertebral height, recovery of vertebral height and cement leakage the increased perioperative HBL during PVP.
分析经皮椎体成形术（PVP）治疗老年骨质疏松性椎体压缩骨折（OVCF）患者围手术期隐性失血（HBL）及其影响因素。
选取2016年1月至2018年12月期间接受PVP治疗的103例老年OVCF患者（年龄>85岁）。记录患者的身高、体重、症状持续时间、既往病史等基本信息。记录入院时及术后次日的血红蛋白（Hb）和血细胞比容（Hct）。记录手术时间、手术出血量、Kummell病、术前及术后椎体高度以及骨水泥渗漏情况。根据Gross公式计算总失血量（TBL），并基于TBL和手术出血量计算HBL。通过多因素线性回归分析和单因素相关性分析对影响因素进行分析。
平均手术出血量为11.83±5.37 mL，HBL为306.19±185.92 mL，差异有统计学意义（P = 0.000）。根据多因素线性回归分析，症状持续时间（P = 0.030）、骨折节段数（P = 0.016）、手术时间（P = 0.004）、椎体高度丢失（P = 0.026）、椎体高度恢复（P = 0.004）、Kummell病（P = 0.040）和骨水泥渗漏（P = 0.004）与HBL量增加相关。性别（P = 0.077）、体重指数（BMI）（P = 0.486）、高血压（P = 0.734）、糖尿病（P = 0.769）、骨折节段（P = 0.518）和手术出血量（P = 0.821）与HBL量无关。
老年OVCF患者PVP围手术期存在明显的HBL。新鲜骨折、多节段椎体骨折、手术时间较长、存在Kummell病、椎体高度丢失、椎体高度恢复和骨水泥渗漏会增加PVP围手术期的HBL。
