摘要
目的测定非骨质疏松骨折围手术期血清25羟基维生素D[25-（OH）-Vit D]水平并对其相关影响因素进行分析。方法研究选取2013年8月至2015年11月在大连医科大学附属第一医院创伤骨科住院的急性非骨质疏松骨折手术患者85例作为非骨质疏松骨折手术组,其中男性58例,女性27例;年龄18-50岁,平均（36±10）岁;同期选取门诊健康体检者90例作为健康对照组,其中男性60例,女性30例,年龄18-50岁,平均（35±9）岁。创伤严重程度根据AIS评分（简明损伤评分）标准,1分11例,2分25例,3分21例,4分13例,5分15例。所有患者均于入院后第1天、手术后拔出引流管当天采集晨空腹静脉血样分别测定血清25-（OH）-Vit D水平和血红蛋白（Hb）含量,统计术中出血量及术后引流量。通过统计学方法分析创伤严重程度、Hb含量、术中出血量等对骨折围手术期血清维生素D水平的影响。结果 （1）非骨质疏松骨折手术组比健康对照组血清25-（OH）-Vit D水平较低,差异具有统计学意义（t=15.43,P〈0.05）,骨质疏松骨折手术组比健康对照组低42.8%;（2）创伤严重程度对伤后维生素D水平影响：各组间总体比较显示损伤越重伤后血清25-（OH）-Vit D水平越低,差异有统计学意义（F=4.78,P〈0.05）,AIS 5分组比AIS 1分血清25-（OH）-Vit D水平低57.6%;（3）伤后Hb含量与维生素D水平的影响：伤后Hb含量越低血清25-（OH）-Vit D水平越低,差异具有统计学意义（F=39.2,P〈0.05）,中重度贫血组比正常组血清25-（OH）-Vit D水平低73.5%;（4）围手术期总出血量对围手术期维生素D变化的影响：总出血量不同5组患者的血清25-（OH）-Vit D水平降低程度总体比较,差异有统计学意义（P〈0.05）,且400 ml≤总出血量〈600 ml时,血清25-（OH）-Vit D降低程度最大,下降35.7%。结论非骨质疏松骨折围手术期血清25-（OH）-Vit D水平与创伤严重程度及出血量有关,骨�
Objective To determine the perioperative serum 25-hydroxy-vitamine D [25-（ OH）-Vit D] level of the patients with non-osteoporotic fractures and analyze its relevant influencing factors.Methods A prospective study was carried out in 85 cases of the patients with acute non- osteoporotic fractures surgery as the fracture group between August 2013 and November 2013 in the department of orthopedics,the First Affiliated Hospital of Dalian Medical University hospital,including 58 men and 27 women,aged from 18 to 50,（ 36 ± 10） years in average. Ninety healthy adult outpatients were selected as the control group during the same period. Traumatic severity was determined according to abbreviated injwred scale（ AIS） scoring criteria. There were 11 cases of AIS 1,25 cases of AIS 2,21 cases of AIS 3,13 cases of AIS 4 and 15 cases of AIS 5. The morning fasting venous blood of all the patients were collected to determine the serum 25-（ OH）-Vit D level and the hemoglobin level on the first day of hospital admission and at the time of pulling out postoperative drainage tube; the volume of intraoperative blood loss and postoperative drainage volume were also recorded. The effects of traumatic severity,hemoglobin level and intraoperative blood loss volume on serum vitamin D level in perioperative period were analyzed by the statistical methods. Results（ 1） The serum 25-（ OH）-Vit D level of the fracture group was 42. 8%lower than the control group,the difference was statistically significant（ t = 15. 43,P〈0. 05）.（ 2） The effects of traumatic severity on serum 25-（ OH）-Vit D level after injury： the overall comparisons between the two groups showed that the more severe the trauma was,the lower the post-injury 25-（ OH）-Vit D level was; the difference was statistically significant（ F = 4. 78,P〈0. 05）. The serum 25-（ OH）-Vit D level of the patients of AIS 5 was 57. 6% lower than the AIS 1 patients.（ 3） The relationship between post-injury hemoglobin level and vitamin D level： th
出处
《中华关节外科杂志（电子版）》
CAS
2016年第4期21-25,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
维生素D
骨折
出血
围手术期医护
Vitamin D
Fractures
bone
Hemorrhage
Perioperative care
