摘要
[目的]探讨人工关节置换术后低氧血症的特点与因素。[方法]回顾分析本院2016年1月~2020年4月61例人工关节置换患者的临床资料。其中,21例患者术后出现低氧血症(低氧血症组),40例患者无低氧血症(血氧正常组)。描述低氧血症发生的特征与血氧饱和度(SpO_(2))的变化,对两组各相关资料采用单项因素和二元多因素逻辑回归分析。[结果]两组患者SpO_(2)均呈曲线改变,低血氧组术后2 d SpO_(2)下降至谷底,术后3 d和术后4 d SpO_(2)水平回升,但仍未达到术前水平;血氧正常组术日SpO_(2)降至谷底,尔后回升,于术后3 d和4 d接近术前水平;两组患者不同时间点SpO_(2)的变化均有统计学意义(P<0.05)。术前两组间SpO_(2)的差异无统计学意义(P>0.05),而术日、术后1、2、3和4 d低氧血症组的SpO_(2)均显著低于血氧正常组(P<0.05)。单项因素比较,低氧血症组在年龄、BMI指数、ASA分级、TKA/THA的比值均显著大于血氧正常组(P<0.05)。逻辑回归表明,高龄(OR=1.114,P=0.041)、高BMI(OR=1.830,P=0.002)以及ASA分级高(OR=15.629,P=0.009)是发生低氧血症的独立危险因素。[结论]关节置换术后低氧血症的发病率较高,特别是高龄、高BMI、高ASA评级的患者易发生低氧血症。
[Objective]To explore the characteristics and risk factors of hypoxemia after major joint arthroplasty of the lower extremity.[Methods]A retrospective study was conducted on 61 patients who received major joint arthroplasty of the lower exteminty in our hospital from January 2016 to April 2020.Among them,21 patients developed hypoxemia(hypoxemia group)and 40 patients did not have hypoxemia(normal blood oxygen group)after operation.The characteristics of the occurrence of hypoxemia and the changes in SpO_(2) were described.In addition,the relevant data of the two group were compared by using univariate analysis and binary multiple logistic regression analysis.[Results]Both group showed a curve change of the SpO_(2).The hypoxemia group revealed that the SpO_(2) dropped to the bottom on the 2nd day after the operation,and the SpO_(2) level rose back on the 3rd and 4th day after the operation,but it still did not reach the preoperative level;in contrast,the normal blood oxygen group presented that the SpO_(2) dropped to the bottom on the operation day and then rose back to near the preoperative level at 3 and 4 days after operation.The changes in SpO_(2) among different time points were statistically significant in both groups(P<0.05).Although there was no a statistically significant difference in SpO_(2) between the two groups preoperatively(P>0.05),the hypoxemia group had significantly lower SpO_(2) than normal blood oxygen group on the day of surgery,at 1 d,2 d,3 d,and 4 d postoperatively(P<0.05).In term of univariate comparison,the hypoxemia group was significantly greater than the normal blood oxygen group regarding to age,BMI,ASA grade and TKA/THA ratio(P<0.05).As result of logistic regression,the advanced age(OR=1.114,P=0.041),high BMI(OR=1.830,P=0.002),and high ASA grade(OR=15.629,P=0.009)were independent risk factors for hypoxemia.[Conclusion]The incidence of hypoxemia after major joint arthroplasty is relatively high,especially in patients with advanced age,high BMI,and high ASA rating.
作者
邹毅
叶茂
冷华伟
张均泉
张玉峰
ZOU Yi;YE Mao;LENG Hua-wei;ZHANG Jun-quan;ZHANG Yu-feng(Department of Orthopaedics,302 Hospital of China Guihang Group,Anshun 561000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第9期814-817,共4页
Orthopedic Journal of China
