The Second Affiliated Hospital of Fujian Medical University, 34 Zhong-shan North Road, Licheng District, Quanzhou City, Fujian Province, China.
J Orthop Surg Res. 2024 Nov 27;19(1):798. doi: 10.1186/s13018-024-05297-4.
To compare hidden blood loss (HBL) of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) of lumbar degenerative diseases in patients with or without osteoporosis (OP) and identify the risk factors for HBL with OP.
The data from 156 patients with lumbar degenerative diseases, who underwent Mis-TLIF between January 2018 and December 2021, were retrospectively analyzed. The patients were divided into the Osteoporosis and Non-osteoporosis groups. We recorded demographic characteristics and blood-related parameters in each group. Blood loss was measured by quantifying visible blood loss and calculating HBL using preoperative hematocrit (Hct) and postoperative hematocrit (Hct). Pearson or Spearman correlation analysis was used to investigate the association between OP patient's characteristics and HBL. Multivariate linear regression analysis was used to confirm independent risk factors of HBL in patients with OP.
The mean HBL of the Osteoporosis and Non-osteoporosis groups was 608.27 ± 175.23 and 173.04 ± 67.55 ml, respectively. There were significant differences in age, BMI, subcutaneous fat thickness, muscle thickness, Hct, average hematocrit of preoperative and postoperative (Hct), visible blood loss, HBL and volume of allogeneic blood transfusions between the two groups (P < 0.05). Multivariate linear regression analysis showed that Hct, T-score, use of tranexamic acid (TXA) and preoperative regular anti-osteoporosis treatment were independent risk factors for HBL in patients with OP.
There was significant perioperative HBL in patients with OP. Hct, T-score, use of TXA and preoperative regular anti-osteoporosis treatment were independent risk factors for HBL in patients with OP. More attention should be paid to the perioperative period to ensure the safety of patients with OP.
比较骨质疏松症（OP）患者与非骨质疏松症（Non-OP）患者行微创经椎间孔腰椎体间融合术（Mis-TLIF）治疗腰椎退行性疾病时的隐性失血（HBL），并确定伴有 OP 的 HBL 的危险因素。
回顾性分析 2018 年 1 月至 2021 年 12 月期间行 Mis-TLIF 的 156 例腰椎退行性疾病患者的临床资料。将患者分为骨质疏松症组（OP 组）和非骨质疏松症组（Non-OP 组）。记录两组患者的一般资料和血液相关参数。通过测量显性失血量并根据术前红细胞压积（Hct）和术后 Hct 计算隐性失血量。采用 Pearson 或 Spearman 相关分析评估 OP 患者的特征与 HBL 之间的相关性。采用多元线性回归分析确认 OP 患者 HBL 的独立危险因素。
OP 组和 Non-OP 组的平均 HBL 分别为 608.27±175.23ml 和 173.04±67.55ml，两组患者的年龄、BMI、皮下脂肪厚度、肌肉厚度、Hct、术前和术后平均 Hct（Hct）、显性失血量、HBL 和异体血输血量均存在显著差异（P<0.05）。多元线性回归分析显示，Hct、T 评分、氨甲环酸（TXA）的使用以及术前常规抗骨质疏松治疗是 OP 患者 HBL 的独立危险因素。
OP 患者围手术期存在明显的隐性失血。Hct、T 评分、TXA 的使用以及术前常规抗骨质疏松治疗是 OP 患者 HBL 的独立危险因素。围手术期应更加关注 OP 患者，以确保患者安全。
