老年股骨转子间骨折患者围手术期血清肌酐尿素氮B型钠尿肽水平变化及临床意义探讨

doi:10.3969/j.issn.1006-6233.2021.06.019

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (2482 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To explore changes of levels of serum creatinine (serum creatinine, Scr), blood urea nitrogen (blood urea nitrogen, BUN) and B-type natriuretic peptide (B-type natriuretic peptide, BNP) in perioperative period of elderly patients with femoral intertrochanteric fractures, and analyze the risk factors for poor prognosis of patients after operation. Methods:The clinical data of 147 elderly patients with intertrochanteric fractures who underwent surgical treatment in the hospital from January 2017 to June 2020 were retrospectively analyzed. According to the occurrence of adverse events, patients were divided into good prognosis group (n=122) and poor prognosis group (n=25). The general clinical data and changes in levels of serum Scr, BUN and BNP at different time points (before surgery, at 12h, 24h, 48h and 72h after surgery) were compared between the two groups. The independent risk factors of poor prognosis were analyzed by multivariate logistic regression analysis. Results:Older age and longer interval from injury to operation are observed in poor prognosis group than those in good prognosis group (P<0.05), and proportion of patients with ASA grading at grade III-IV, preoperative abnormal renal function and difference value of perioperative fluid intake and output not lower than 500mL was higher than that in good prognosis group (P<0.05). There were no significant differences in gender, history of underlying diseases, operation time, hospitalization time and anesthesia method between the two groups (P>0.05). After surgery, levels of serum Scr and BNP were increased and then decreased, and level of serum BUN was gradually increased in poor prognosis group. The levels of serum Scr, BUN and BNP were increased and then decreased in good prognosis group. The levels of serum Scr, BUN and BNP in the two groups showed statistically significant differences in terms of inter-group effect, time effect, and interaction effect (P<0.05). At 48h and 72h after operation, the poor prognosis group had significantly higher serum BUN levels than the good prognosis group (P<0.05). At 12h, 24h, 48h and 72h after operation, serum BNP and Scr levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05).Logistic regression analysis showed that age, ASA grading at grade III-IV, difference value of perioperative fluid intake and output not lower than 500mL, levels of serum Scr, BUN and BNP levels at 72h after surgery were influencing factors of poor prognosis in elderly patients with intertrochanteric fractures (P<0.05). Conclusion:Influencing factors for postoperative poor prognosis in elderly patients with intertrochanteric fractures include age, ASA grading at grade III-IV, difference value of perioperative fluid intake and output not lower than 500mL, levels of serum Scr, BUN and BNP levels at 72h after surgery. The real-time monitoring on levels of serum Scr, BUN and BNP levels at 72h after surgery, and taking effective intervention measures can improve their prognosis.

Key words： Femoral intertrochanteric fracture Elderly patient Serological index Prognosis Risk factor

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	JIANG Mingju
	HU Yong

Cite this article:

JIANG Mingju,HU Yong. Changes of Levels of Serum Creatinine Urea Nitrogen and B-Natriuretic Peptide in Perioperative Period of Elderly Patients with Femoral Intertrochanteric Fractures and the Clinical Significance[J]. HeBei Med, 2021, 27(6): 968-974.

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.06.019 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I6/968

[1] Kempegowda H,Richard R,Borade A,et al.Obesity is associated with high perioperative complications among surgically treated intertrochanteric fracture of the femur[J].Orthop Trauma,2017,17(1):1251~1256.
[2] 李明东,胡稷杰,黎早敏,等.不同手术方式治疗老年股骨粗隆间骨折的疗效比较[J].中国修复重建外科杂志,2017,31(6):653~658.
[3] 张鹏,徐峰,王磊,等.股骨近端锁定钢板治疗老年股骨转子间骨折术后并发症原因分析及防治对策[J].中国矫形外科杂志,2017,25(18):1647~1651.
[4] Dai C Q,Wang LH,Zhu YQ,et al.Risk factors of perioperative blood transfusion in elderly patients with femoral intertrochanteric fracture[J].Medicine,2020,99(15):e19726.
[5] 孙智路,谭位华,周佳,等.法舒地尔对急性有机磷中毒大鼠的心与肾功能的保护作用[J].中国临床药理学杂志,2019,35(6):22~25.
[6] Cho J,Park IB,Lee K,et al.Statin has more protective effects in AMI patients with higher plasma BNP or NT-proBNP level,but not with lower left ventricular ejection fraction[J].JCardiol,2018,71(4):375~381.
[7] 中华医学会骨科学分会青年骨质疏松学组,中国医师协会急救复苏专业委员会创伤骨科与多发伤学组,上海市中西医结合学会骨质疏松专业委员会.中国骨质疏松性骨折围手术期处理专家共识(2018)[J].中国临床医学,2018,25(5):860~866.
[8] 胡文兰,陈游洲,王继红,等.骨科手术患者围手术期肌钙蛋白升高的临床特点分析[J].中华内科杂志,2018,57(5):340~344.
[9] 张谊雯,刘剑华.血液中肾损伤分子-1(KIM-1)和血清肌酐(SCr)对AKI的生物标志物作用[J].基因组学与应用生物学,2020,18(3):125~129.
[10] 王婷,李结华.hs-CRP、BNP和cTnI联合检测对急性心肌梗死患者PCI术后MACE的预测价值[J].重庆医学,2017,46(3):380~382.
[11] Baquero GA,Rich MW.Perioperative care in older adults[J].Geriatr Cardiol,2017,12(5):465~469.
[12] 冯壵,金丹.围手术期不同生化指标在预估老年股骨转子间骨折术后早期死亡中的价值与临床意义[J].中华创伤骨科杂志,2017,18(4):301~305.