术前糖化血红蛋白水平对合并2型糖尿病的老年髋部骨折病人预后的影响

doi:10.3969/j.issn.1005-6483.2021.02.020

摘要/Abstract

摘要： 目的：探讨术前糖化血红蛋白(hemoglobin A1c，HbA1c)水平对合并2型糖尿病(type 2 diabetes mellitus，T2DM)的老年髋部骨折病人预后的影响。方法：2014年1月～2019年10月我院行手术治疗的合并2型糖尿病老年髋部骨折病人97例，根据术前HbA1c水平将其分为A组(HbA1c<6.5%，47例)和B组(HbA1c≥6.5%，50例)，比较两组病人术后疼痛VAS评分、术后髋关节功能Harris评分、术后并发症发生率、手术时间、住院时间、拆线时间和转子间骨折愈合时间。结果：、6个月Harris评分低于A组，差异有统计学意义(P＜0.05)；两组手术时间比较，差异无统计学意义(P>0.05)。结论：合并2型糖尿病的老年髋部骨折病人，术前高水平的HbA1c可能提示预后不佳，关注术前HbA1c水平并采取相关措施有利于促进髋关节功能恢复以及降低术后并发症的发生率。

关键词: 髋部骨折, 2型糖尿病, 糖化血红蛋白, 老年, 手术, 预后

Abstract: Objective：To investigate the effect of preoperative hemoglobin A1c(HbA1c) level on the clinical prognosis of hip fracture in elderly patients with type 2 diabetes mellitus.Methods：The clinical data of 97 elderly patients with hip fracture complicated with type 2 diabetes mellitus who underwent surgery in our hospital from January 2014 to October 2019 were retrospectively analyzed.They were divided into group A(HbA1c<6.5%，n=47) and group B(HbA1c≥6.5%，n=50) according to their preoperative HbA1c level,VAS score of pain at 2,7 and 14 days after operation，Harris score of postoperative hip joint function,incidence of postoperative complications,operation time,hospital stay,suture removal time and intertrochanteric fracture healing time were analyzed and compared between the two groups.〖WTHZ〗Results〓〖WTBZ〗The VAS score of pain at 2,7 and 14 days after operation,postoperative complication rate,hospitalization time,suture removal time and complete intertrochanteric fracture healing time in group B were significantly higher than those in group A after operation,while the Harris scores at 1,3 and 6 months after operation in group B were significantly lower than those in group A(P＜0.05),but there was no significant difference in operation time between the two groups(P>0.05).Conclusion：For the elderly hip fracture patients with type 2 diabetes mellitus,the preoperative high level of HbA1c may indicate a poor clinical prognosis.Paying attention to the preoperative HbA1c level and taking relevant measures can promote the recovery of hip joint function,reduce the incidence of postoperative complications.

Key words: hip fractures, type 2 diabetes, hemoglobin A1c, elderly, surgery, prognosis

彭博成, 李宗焕, 漆白文. 术前糖化血红蛋白水平对合并2型糖尿病的老年髋部骨折病人预后的影响[J]. 临床外科杂志, 2021, 29(2): 165-168.

参考文献

相关文章 15

[1]	马鑫, 宣云东, 黄庆波, 张旭. 肾癌合并下腔静脉癌栓的机器人手术策略[J]. 临床外科杂志, 2021, 29(2): 104-107.
[2]	陈宇, 方汉林, 刘闻. 全胸腔镜手术对肺癌病人的肿瘤标志物神经元特异烯醇化酶、降钙素原、CD3+、CD4+和CD8+的影响[J]. 临床外科杂志, 2021, 29(2): 140-142.
[3]	向青天, 王通卫, 王继军. 高龄髋部骨折个体化治疗54例体会[J]. 临床外科杂志, 2021, 29(2): 142-143.
[4]	张亦超, 胡航, 钱群. 隐源性多灶性溃疡性狭窄性小肠炎八例诊疗经验[J]. 临床外科杂志, 2021, 29(2): 144-147.
[5]	窦宁, 谭晶晶, 李子林. 动脉导管未闭介入治疗日间手术的短期临床结果[J]. 临床外科杂志, 2021, 29(2): 178-180.
[6]	王全晖, 拜云虎, 袁守信. 双镜联合治疗胆总管结石术中不同一期缝合方式对病人的疗效及预后的影响评估[J]. 临床外科杂志, 2021, 29(2): 181-183.
[7]	李霖, 潘秀武, 崔心刚. 肾门肿瘤的腹腔镜手术难点和技巧改进[J]. 临床外科杂志, 2021, 29(2): 195-198.
[8]	张志伟陈孝平. 肝细胞癌外科手术方式的选择[J]. 临床外科杂志, 2021, 29(1): 4-6.
[9]	周超李文涛王瑞方文涛. 双镜联合治疗同时性多原发肺癌13例临床分析[J]. 临床外科杂志, 2021, 29(1): 38-41.
[10]	王志伟冯晶刘伟夏平. 经皮椎间孔镜罕见并发症类脊髓高压综合征一例报道[J]. 临床外科杂志, 2021, 29(1): 50-52.
[11]	马伯恒吴颖王霞. 老年乳腺癌围手术期感染的临床观察[J]. 临床外科杂志, 2021, 29(1): 71-73.
[12]	杨晓华吴淑华. 磷脂酰肌醇3-激酶p110α/β在甲状腺乳头状癌组织中的表达及与预后的相关性[J]. 临床外科杂志, 2021, 29(1): 74-77.
[13]	杨俊杨为民. 寡转移前列腺癌的手术治疗[J]. 临床外科杂志, 2021, 29(1): 96-98.
[14]	张恒张劲松熊波波王海峰左毅刚王剑松. 单中心后腹腔镜肾盂成形术的疗效及学习曲线分析[J]. 临床外科杂志, 2021, 29(1): 99-100.
[15]	戴晓江. 关于袖状胃切除术现状和未来的思考[J]. 临床外科杂志, 2020, 28(9): 807-809.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

本文评价

推荐阅读 10

[1]	于振涛. 食管胃交界腺癌手术治疗现状[J]. 临床外科杂志, 2016, 24(7): 537 .
[2]	陈椿. 微创食管癌切除术——福建医科大学之经验[J]. 临床外科杂志, 2016, 24(7): 560 .
[3]	周观金彭昊陈森. 865例锁骨中段骨折手术治疗分析[J]. 临床外科杂志, 2016, 24(9): 714 .
[4]	陈晋;王晓龙;朱日祥. 影响肝癌合并门脉高压症患者行R0切除的疗效、安全性及预后的因素分析[J]. 临床外科杂志, 2017, 25(3): 182 .
[5]	胡波勇;龚仁杰;韩明;等. 良性前列腺增生患者残余尿量对发生泌尿系感染的预测分析[J]. 临床外科杂志, 2017, 25(4): 287 .
[6]	吴荣华;钟晓;胡文刚等. 腹腔镜下原位低温灌注技术在肾肿瘤部分切除术中的运用[J]. 临床外科杂志, 2017, 25(6): 466 .
[7]	王国义梁剑峰田锦林鲍峰. 内镜直视与X线透视下支架置入术治疗晚期食管贲门癌临床疗效比较[J]. 临床外科杂志, 2018, 26(9): 679 -682 .
[8]	邵文雨, 黄新立, 周浩明等. 公民器官捐献供体质量对肝移植术后受体生存率的影响及其感染高危因素分析[J]. 临床外科杂志, 2018, 26(12): 913 -916 .
[9]	李智, 卫中庆, 王振中, 赵启群, 杨健. 超声电导微波治疗前列腺结石对病人排尿功能和性功能的影响[J]. 临床外科杂志, 2019, 27(2): 118 -120 .
[10]	梁波. 陈旧性冈上肌肌腱撕裂合并功能障碍病人的肩关节镜修复及松解治疗[J]. 临床外科杂志, 2019, 27(4): 316 -319 .