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入院水合状态对老年髋部骨折围术期急性并发症的影响
作者:张琛海  邓桂彬  钟诚凡  梁荣伟 
单位:高州市人民医院 骨外科一区, 广东 高州 525200
关键词:脱水 髋部骨折 急性并发症 老年人 
分类号:R683.42
出版年·卷·期(页码):2020·39·第五期(627-630)
摘要:

目的:探讨髋部骨折老年患者的入院水合状态对围术期急性并发症的影响。方法:2013年1月至2018年6月期间前瞻性调查了332例因髋部骨折住院的老年患者。根据急诊、住院期间首2次血浆渗透压的均值,将患者分为正常水合组(275~295 mmol·L-1)、脱水倾向组(295~300 mmol·L-1)、脱水组(>300 mmol·L-1),比较各组患者住院期间压疮、下肢深静脉血栓、术后认知功能障碍、便秘等急性并发症的发生情况。结果:332例患者平均住院(15.88±5.71)d,其中脱水倾向患者占44.87%,脱水患者占22.28%,且随年龄增大脱水及脱水倾向患者增多(P<0.05)。年龄在75岁以下的脱水组患者中,53.84%发生压疮,57.69%发生术后认知功能障碍,79.92%发生便秘;年龄在75~90岁的脱水组患者中,48.71%发生压疮,71.79%发生术后认知功能障碍,82.05%发生便秘。同年龄段不同水合状态组间比较压疮、术后认知功能障碍、便秘发生率差异具有统计学意义(P<0.05),但下肢深静脉血栓发生率差异无统计学意义(P>0.05)。结论:脱水、脱水倾向是老年人群髋部骨折后常见的病理水合状态,可增加住院期间发生压疮、术后认知功能障碍、便秘等急性并发症的风险。

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