首页|吸烟、超重和酗酒共同影响股骨颈骨折内固定术后股骨头坏死的回顾性研究

吸烟、超重和酗酒共同影响股骨颈骨折内固定术后股骨头坏死的回顾性研究

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目的 探讨吸烟、超重、酗酒与血浆PAI-1和股骨颈骨折内固定术后股骨头坏死之间的关系.方法 2021年1月~2022年1月因股骨颈骨折行内固定治疗的病人95例,收集病人吸烟、超重、酗酒、术前和术后2天血浆PAI-1水平等资料;根据末次随访股骨头坏死发生情况将病人分为坏死组和非坏死组,对吸烟、超重、酗酒、术前和术后2天血浆PAI-1水平进行单因素分析,并对同时存在吸烟、超重和酗酒因素的情况进行分析;分析吸烟、超重和酗酒共同或分别作为独立单因素时与血浆PAI-1水平的关系;明确吸烟、超重、酗酒与血浆PAI-1和内固定术后股骨头坏死之间的关系.结果 95例病人出现股骨头坏死22例,年龄、性别、吸烟、超重和酗酒均不是术后股骨头坏死的独立危险因素(P>0.05);坏死组术后2天血浆PAI-1水平为(46.95±2.35)ng/ml,显著高于非坏死组的(41.94±4.73)ng/ml(P<0.05);同时有吸烟、超重和酗酒因素的病人术后2天血浆 PAI-1 为(48.29±1.78)ng/ml,显著高于其余病人的(42.40±4.60)ng/ml(P<0.05);此外,吸烟、超重和酗酒同时存在且共同作为独立因素时是股骨头坏死的危险因素(P<0.05).结论 吸烟、超重和酗酒同时存在且共同作为独立因素时可增加内固定术后股骨头坏死发生风险,该现象可能与吸烟、超重和酗酒显著上调血浆PAI-1水平尤其是术后2天PAI-1水平有关.
Retrospective study on the influence of smoking,overweight and alcoholism on femoral head necrosis after internal fixation of femoral neck fracture
Objective Investigating the relationship between smoking,overweight,and bibulosity with plasma PAI-1 and osteonecrosis of the femoral head after internal fixation by retrospective study,and providing reference for clinical treatment.Methods A total of 95 patients with femoral neck fracture treated with internal fixation from January 2021 to January 2022 were retrospectively studied.The data of smoking,overweight,alcohol abuse,preoperative and postoperative plasma PAI-1 levels were collected.The patients were divided into necrosis group and non-necrosis group according to the occurrence of femoral head necrosis at the last follow-up.Univariate analysis was performed on smoking,overweight,alcohol abuse,plasma PAI-1 level before and 2 days after operation,and the presence of smoking,overweight and bibulosity factors was analyzed.The association of smoking,overweight and bibulosity with plasma PAI-1 level was analyzed.Figure out the relationship between smoking,overweight,bibulosity and plasma PAI-1 and femoral head necrosis after internal fixation.Results Femoral head necrosis occurred in 22 of 95 patients.Age,gender,smoking,overweight and bibulosity were not independent risk factors for postoperative femoral head necrosis(P>0.05).The plasma PAI-1 level at 2 days after operation in necrosis group was(46.95±2.35)ng/ml,which was significantly higher than that in non-necrosis group[(41.94±4.73)ng/ml,P<0.05].The level of plasma PAI-1 at 2 days after operation was(48.29± 1.78)ng/ml in patients with smoking,overweight and alcohol abuse at the same time,which was significantly higher than that in other patients[(42.40±4.60 ng/ml,P<0.05].In addition,when the smoking,overweight,and bibulosity were concurrent,it was a risk factor for femoral head necrosis(P<0.05).Conclusion When the smoking,overweight,and bibulosity were concurrent,it can increases the risk of osteonecrosis of the femoral head after internal fixation,which may be related to the significant increase of plasma PAI-1 level,especially at 2 days after surgery.

femoral neck fracturesosteonecrosis of the femoral headsmokingoverweightbibulosityPAI-1

高扬、董海鹏、刘峰、王文娟、刘超

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050000 石家庄市第三医院创伤一科

股骨颈骨折 股骨头坏死 吸烟 超重 酗酒 PAI-1

河北省医学科学研究项目

20231642

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(5)
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