临床外科杂志 ›› 2020, Vol. 28 ›› Issue (11): 1047-1050.doi: 10.3969/j.issn.1005-6483.2020.11.015

• 论著 • 上一篇    下一篇

术前低白蛋白血症对初次髋关节置换术后并发症的影响

  

  1. 武汉大学中南医院关节与运动医学科 
  • 出版日期:2020-11-20 发布日期:2020-11-20

The effect of preoperative hypoalbuminemia on complications after primary hip arthroplasty

  • Online:2020-11-20 Published:2020-11-20

摘要: 目的:探讨术前低白蛋白血症发生的危险因素和对初次髋关节置换术后并发症的影响。方法:2019月1月~2019年10月我院收治的行髋关节置换手术的老年住院病人152例。根据血清白蛋白水平分成两组,对照组100例,血清白蛋白≥35g/L;病例组52例,血清白蛋白<35g/L。对两组病人围手术期情况进行比较,分析术前低白蛋白血症发生的相关风险因素,以及术后临床常见并发症与术前低白蛋白血症的关系。结果:与对照组比较,病例组病人年龄更大,体重指数(BMI)更低,骨折病人占比更高,美国麻醉医师协会(ASA)评分和心功能评分更高,住院时间更长,病例组病人术后总计并发症的发生率更高。两组接受的手术方式、麻醉方式、术中时间和术中出血量比较无明显差异。结论:年龄较大、营养状况较差、合并症较多的病人,更容易出现术前低白蛋白血症。术前低白蛋白血症与多种术后并发症发生率增加有关。正确地术前白蛋白水平评估和处理,有利于减少初次髋关节置换手术的术后并发症的风险。

关键词: 低白蛋白血症, 髋关节置换术, 危险因素, 并发症

Abstract: Objective:To explore the risk factors of preoperative hypoalbuminemia and the effects of hypoalbuminemia on complications after the primary hip arthroplasty.Methods:A total of 152 elderly hospitalized patients who underwent hip arthroplasty in the Zhongnan Hospital of Wuhan University from January 2019 to October 2019 were collected. All patients were divided into control group (serum albumin ≥ 35g/L,100 cases) and case group (serum albumin < 35g/L,52 cases). The perioperative conditions of the two groups of patients were recorded and compared. The relevant risk factors of preoperative hypoalbuminemia and the relationship between preoperative hypoalbuminemia and postoperative complications were analyzed.Result:Compared to the control group, the patients in the case group were older, had lower BMI, more likely fracture patients, had longer lengths of stay, the American Society of Anesthesiologists (ASA) scores and cardiac function scores were higher.Compared to controls, hypoalbuminemia patients had higher risk for any complications. There were no significant differences in surgical methods, anesthesia methods, intraoperative time, and intraoperative blood loss between the two groups.Conclusion:Patients who were older and have more comorbidities are more likely to have preoperative hypoalbuminemia.Preoperative hypoalbuminemia is associated with an increased incidence of various postoperative complications. The findings in the present study indicate the need to develop better pre and postoperative medical and nutritional care for primary hip arthroplasty patients in order to potentially mitigate their increased risk.

Key words: hypoalbuminemia, hip arthroplasty, risk factors, postoperative complications

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