血清白蛋白、血红蛋白水平和淋巴细胞计数对老年髋部骨折手术患者预后的影响

摘要

Objective To investigate the effects of serum albumin, hemoglobin levels and lymphocyte counts on the prognosis of elderly patients after hip fracture surgery. Methods Clinical data of 86 elderly patients with unilateral hip fracture treated surgically in Sanshui Hospital of Foshan Hospital of Chinese Traditional Medicine from April 2010 to April 2013 were analyzed retrospectively. Patients were divided into survival group (n = 79) and death group (n = 7) according to the prognosis condition after one year's follow-up. Serum albumin, hemoglobin levels and lymphocyte counts at admission date were compared between two groups, and the differences of mortality rates were analyzed between patients at normal levels and abnormal levels in serum. Results In survival group, levels of serum albumin and hemoglobin at admission date were higher than those in death group (P <0.05), while lymphocyte counts had no statistical differences between two groups (P >0.05). Mortality rates in patients with nomal serum albumin and hemoglobin levels were lower than those in patients with abnormal levels (P <0.05); while there were no statistical differences of mortality rates between patients with normal and abnormal lymphocyte counts (P >0.05). Multiple logistic regression analysis showed that low levels of serum albumin and hemoglobin were the major risks of mortality for elderly patients undergoing hip fracture surgery (P <0.05). Conclusions Serum albumin and hemoglobin levels have significant influences on the prognosis of elderly patients after hip fracture surgery, as a result, the parameters could be used as important indexes for prognosis evaluation.%目的：探讨血清白蛋白、血红蛋白水平和淋巴细胞计数对老年髋部骨折手术患者预后的影响。方法回顾性分析2010年4月至2013年4月佛山市中医院三水医院收治的86例采用手术治疗的老年单侧髋部骨折患者的临床资料，根据随访1年时患者生存状态分为生存组（79例）和死亡组（7例），对比两组患者入院时血清白蛋白、血红蛋白水平和淋巴细胞计数，分析正常和异常水平患者死亡率的差异。结果生存组患者血清白蛋白、血红蛋白水平均高于死亡组，两组比较，差异有统计学意义（P＜0.05）；两组淋巴细胞计数比较，差异无统计学意义（P＞0.05）。血清白蛋白、血红蛋白水平正常患者死亡率均低于水平降低患者（P＜0.05）；淋巴细胞计数正常与降低患者死亡率比较，差异无统计学意义（P＞0.05）。多因素Logistic回归分析结果显示，血清白蛋白、血红蛋白降低是老年髋部骨折手术患者死亡的主要危险因素（P＜0.05）。结论血清白蛋白、血红蛋白水平对老年髋部骨折手术患者预后影响显著，可作为患者预后判断的重要指标。