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[1]郑晓飞,刘国印,蒋逸秋,等.血清营养学指标与全髋关节置换术失血的相关研究[J].医学研究与战创伤救治(原医学研究生学报),2016,18(05):475-478.[doi:10.3969/j.issn.1672-271X.2016.05.008]
　ZHENG Xiao-fei,LIU Guo-yin,JIANG Yi-qiu,et al.The correlational study between hidden blood loss and serological examinations[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(05):475-478.[doi:10.3969/j.issn.1672-271X.2016.05.008]
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血清营养学指标与全髋关节置换术失血的相关研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第18卷
期数:
2016年05期
页码:
475-478
栏目:
出版日期:
2016-09-20

文章信息/Info

Title:
The correlational study between hidden blood loss and serological examinations
作者:
郑晓飞1; 2; 刘国印2; 蒋逸秋1; 张勇2; 陈建民2; 桂鉴超1
1. 210006江苏南京，南京医科大学附属南京医院骨科；2. 210002江苏南京，解放军81医院骨科
Author(s):
ZHENG Xiao-fei1; 2;  LIU Guo-yin2;  JIANG Yi-qiu1;  ZHANG Yong2;  CHEN Jian-min2;  GUI Jian-chao1
1. Department of Orthopedics, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing，Jiangsu 210006, China; 2. Department of Orthopaedics, 81 Hospital of PLA, Nanjing，Jiangsu 210002, China
关键词:
股骨颈骨折; 全髋关节置换; 隐性失血; 血清营养学指标
Keywords:
hip fractures;  total hip replacement;  hidden blood loss;  serological examination
分类号:
R687.4
DOI:
10.3969/j.issn.1672-271X.2016.05.008
文献标志码:
A
摘要:
目的 探讨血清营养学指标与全髋关节置换隐性失血之间的相关性。方法 根据患者术中失血量、术后出血量、手术前后红细胞压积和输血量，计算患者的总失血量、隐性失血量、原血量和总失血量的比例，按照平均隐性失血量占总失血量的比,分低隐失血组和高隐失血组，分析高隐失血与术前血清营养学指标总蛋白（TP）、白蛋白（ALB）、前白蛋白(PA)、转铁蛋白(TRA)、淋巴细胞计数(TLC)、淋巴细胞百分比(TLP)、血红蛋白(HB）之间的关系。结果 所有患者失血量平均为1298.47 mL，占原血量的30.13%；隐性失血总量平均517.03 mL，占总失血量的39.82%；101例患者发生高隐性失血，高隐性失血量组术前ALB、PA、TRA和TLP的平均数值明显低于低隐失血量组（P<0．05），高隐性失血量组术前ALB、PA、TRA、TLC、TLP和HB评估的隐性失血发生率明显高于低隐失血量组（P<0．05），高隐失血与ALB、PA、TRA、TLP和HB相关性强（相关系数分别为0. 587、0. 517、0. 687、0.395和0. 387，均P<0.05)。结论 血清营养学指标（ALB、PA、TRA、TLP和HB）与关节置换术后高隐性失血紧密相关，判断高隐性失血的重要指标。
Abstract:
Objective To identify the correlation between hidden blood loss and serological examinations. Methods The total blood loss, hidden blood loss and their proportion on the original blood volume and total blood loss was calculated depending on height, weight, intra-operative blood loss, post-operative blood loss, pre -and post-operative Hct, and blood transfused. According to the proportion of mean hidden blood loss on total blood loss, patients were divided into low hidden blood loss group and high hidden blood loss group. Then, we analyzed the relationship among high hidden blood loss and preoperative serological examinations (TP, ALB, PA, TRA, TLC, TLP and Hb). Results The mean total blood loss was 1298.47 mL, accounting for 30.13% of the original blood volume. The mean hidden blood loss was 517.03 mL, accounting for 39.82% of the total blood loss. 101 of 234 cases were found to have high hidden blood loss, and the preoperative data of ALB, PA, TRA and TLP in high hidden blood loss group was higher than that in low hidden blood loss group (P<0.05). The preoperative incidence of hidden blood loss assessed by ALB, PA, TRA, TLC, TLP and Hb in high hidden blood loss group was markedly higher than that in low hidden blood loss group (P<0.05). The preoperative ALB, PA, TRA, TLP and Hb showed strong correlation with high hidden blood loss (correlation coefficients was 0. 587, 0. 517, 0. 687, 0.395 and 0. 387, respectively, P<0.05). Conclusion The serological examinations (ALB, PA, TRA, TLP and Hb) had significant value in predicting the risk of high hidden blood loss and could be considered as important indicators for judging high hidden blood loss.

参考文献/References:

[1]Atay IM, Aslan A, Burc H, et al. Is depression associated with functional recovery after hip fracture in the elderly?[J]. J Orthop,2016,13(2):115-118.
[2]丁敏,祁伟,刘方刚,等.氨甲环酸在人工全髋关节置换术中局部应用的疗效分析[J].医学研究生学报,2014,27(8):833-835.
[3]Saletti-Cuesta L, Tutton L, Wright J. The relevance of gender in the care of hip fracture patients[J]. Int J Orthop Trauma Nurs,2016,22:3-12.
[4]Pedersen AB, Christiansen CF, Gammelager H, et al. Risk of acute renal failure and mortality after surgery for a fracture of the hip: a population-based cohort study[J]. Bone Joint J,2016,98-B(8):1112-1118.
[5]王兴元，曹洪兵，范丽娟，等. 肌钙蛋白对髋部骨折患者短期和长期病死率的预测作用[J]. 东南国防医药,2015，17(4):368-371.
[6]Leu TH, Chang WC, Lin JC, et al. Incidence and excess mortality of hip fracture in young adults: a nationwide population-based cohort study[J]. BMC Musculoskelet Disord,2016,17:326. doi: 10.1186/s12891-016-1166-9.
[7]Oliver D. David Oliver: Hip fracture care shows the way[J]. BMJ,2016,354:i3979. doi: 10.1136/bmj.i3979. No abstract available.
[8]Roh HW, Hong CH, Lee S, et al. Frontal Lobe Function and Risk of Hip Fracture in Patient With Alzheimer Disease: An Analysis of Linked Data[J]. Medicine (Baltimore),2015,94(45):e1918..
[9]叶春，张忻平，王希泽，等. 老年胃癌患者围手术期营养评估及术后早期肠内营养的临床研究[J]. 东南国防医药,2015，17(6):579-582.
[10]Kieffer WK, Rennie CS, Gandhe AJ. Preoperative albumin as a predictor of one-year mortality in patients with fractured neck of femur[J]. Ann R Coll Surg Engl,2013,95(1):26-28.
[11]Koren-Hakim T, Weiss A, Hershkovitz A, et al. The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome[J]. Clin Nutr,2012,31(6):917-921.
[12]Salminen H, Saaf M, Johansson SE, et al. Nutritional status, as determined by the Mini-Nutritional Assessment, and osteoporosis: a cross-sectional study of an elderly female population[J]. Eur J Clin Nutr,2006,60(4):486-493.
[13]Flodin L, Cederholm T, Saaf M, et al. Effects of protein-rich nutritional supplementation and bisphosphonates on body composition, handgrip strength and health-related quality of life after hip fracture: a 12-month randomized controlled study[J]. BMC Geriatr,2015,15:149.
[14]Koren-Hakim T, Weiss A, Hershkovitz A, et al. Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients[J]. Clin Nutr,2016,35(5):1053-1058.
[15]Nuotio M, Tuominen P, Luukkaala T. Association of nutritional status as measured by the Mini-Nutritional Assessment Short Form with changes in mobility, institutionalization and death after hip fracture[J]. Eur J Clin Nutr,2016,70(3):393-398.
[16]Koren-Hakim T, Weiss A, Hershkovitz A, et al. The relationship between nutritional status of hip fracture operated elderly patients and their functioning, comorbidity and outcome[J]. Clin Nutr,2012,31(6):917-921.
[17]Myint MW, Wu J, Wong E, et al. Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial[J]. Age Ageing,2013,42(1):39-45.
[18]Wyers CE, Reijven PL, Evers SM, et al. Cost-effectiveness of nutritional intervention in elderly subjects after hip fracture. A randomized controlled trial[J]. Osteoporos Int,2013,24(1):151-162.
[19]Flodin L, Saaf M, Cederholm T, et al. Additive effects of nutritional supplementation, together with bisphosphonates, on bone mineral density after hip fracture: a 12-month randomized controlled study[J]. Clin Interv Aging,2014,9:1043-1050.
[20]Gumieiro DN, Rafacho BP, Goncalves AF, et al. Mini Nutritional Assessment predicts gait status and mortality 6 months after hip fracture[J]. Br J Nutr,2013,109(9):1657-1661.
[21]Gunnarsson AK, Akerfeldt T, Larsson S, et al. Increased energy intake in hip fracture patients affects nutritional biochemical markers[J]. Scand J Surg,2012,101(3):204-210.

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备注/Memo

备注/Memo:
江苏省科教兴卫工程医学领军人才基金(LJ201106)
更新日期/Last Update: 2016-12-09