摘要
目的研究老年髋部骨折围术期输血与临床预后的关系。方法回顾性地分析解放军总医院2010年～2012年期间连续性收治的所有老年髋部骨折患者，将最低血红蛋白（Hb）〉80g／L的患者按照围术期是否输血分为输血组及未输血组。比较两组患者术后并发症及术后1个月、12个月死亡率差异，分析围术期输血与术后死亡的相关性。结果共纳入931例患者，706（75．8％）例患者接受输血治疗，输血组最低Hb浓度为（105．2±15．4）g／L，未输血组最低Hb浓度为（110．5±16．5）g／L。输血组术后心脑血管并发症发生率明显高于未输血组（7．5％VS3．6％，P=0．037），两组患者术后感染性并发症及死亡率差异均无统计学意义（均P〉0．05）。多因素分析结果显示高龄及低Hb浓度为术后死亡的独立危险因素，而输血并非影响死亡的独立因素。结论高龄和低Hb浓度是老年髋部骨折患者术后死亡的独立危险因素，但围术期输血并不能明显改善患者预后。
Objective To investigate the relationship ofperioperative blood transfusion with clinical prognosis in the elderly hip fracture patients. Methods Consecutive elderly patients （over 60 years old） with hip fracture admitted in our department during the years of 2010 to 2012 were subjected and retrospectively analyzed. All patients with the lowest hemoglobin （Hb） concentration 〉 80g/L were divided into 2 groups, receiving red blood cell transfusion （transfusion group） or not （control group）. The incidence of postoperative complications and 1-month or 12-month mortality were compared between the 2 groups. The correlation of perioperative blood transfusion with postoperative death was analyzed. Results A total of 931 patients were recruited in this study. There were 706 （75.8%） patients receiving red blood cell transfusion, from them the mean lowest Hb in concentration was （105.2 ± 15.4）g/L. And among the patients without blood transfusion the lowest Hb concentration was （110.5 ± 16.5）g/L. The incidence of postoperative cardiovascular complications was obviously higher in the transfusion group than than in control group （7.5% vs 3,6%, P = 0.037）, but there was no significant difference in postoperative infectious complications or mortality between the 2 groups （P 〉 0.05）. Multivariate analysis showed that senior age and low Hb concentration were independent risk factors for postoperative death, but blood transfusion was not. Conclusion Senior age and low Hb concentration are independent risk factors for elderly patients suffering hip fractures, but perioperative blood transfusion can not improve the outcomes of these patients.
出处
《中华老年多器官疾病杂志》
2014年第7期485-488,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
卫生行业专项基金（201302007）
关键词
髋骨折
贫血
输血
死亡率
hip fractures
anemia
blood transfusion
mortality This work was supported by the Special Fund of Health lndustry （201302007）. Corresponding author： TANG Pei-Fu, E-mail： pftang301@126.com
