摘要
[目的]分析老年股骨转子间骨折围手术期失血的特点及相关影响因素,为围术期处理提供必要的数据。[方法]分析本院2009年10月～2012年10月在本科手术治疗的93例老年股骨转子间骨折患者。其中动力髋螺钉内固定(DHS)38例,防旋型股骨近端髓内钉(PFNA)内固定55例,所有病例均为单侧首发新鲜患者。应用Gross方程,根据身高、体重、手术前后的红细胞压积(HCT)及术中、术后出血进行分析,对患者围术期的出血情况进行评估。[结果]DHS组病例平均隐性失血量为468 ml,PFNA组病例平均隐性失血量为554 ml。隐性失血占失血总量的比例分别为80.6%和89.4%,隐性失血是围手术期失血的主要原因。围手术期失血量与性别、年龄、身高、体重、骨折类型有相关性;DHS组与PFNA组间失血量有明显差异。[结论]应该重视患者性别、年龄、身高、体重、手术方式等影响围手术期失血的因素,严格注意患者的生命体征监测,围手术期应及时补充血容量,减少并发症的产生。
[ Objective] To analyze the perioperative blood loss after surgery for elderly patients in intertrochanteric fractures and the relative factors to provide the data for clinical treatment in perioperative period. [ Method] The clinical data of 38 cases of intertrochanteric fracture patients treated with DHS and 55 cases of intertrochanteric fracture patients treated with PFNA from October 2009 to October 2012 were retrospectively analyzed. All the cases were fresh intertrochanteric fracture following primary operation. According to Gross formulae,we calculated the total blood loss with the patients＇ height, weight, Hct, to evaluate the perioperative blood loss after Surgery. [ Result] The mean hidden blood loss were 468 ml in DHS group, about 80.6% of the to-tal blood loss volume. In PFNA group, the number was 554 ml and 89.4%. Hidden blood loss was the major part of the perioper- ative blood loss in intertrochanteric fracture. The blood loss was relative with the gender, age, height, weight, fracture type. There was significant difference in the blood loss between DHS group and PFNA group. [ Conclusion ] Much attention should be paid to the relative factors and the vital signs of the patients in the perioperative period, to supplement the blood volume during perio-perative period after surgery in time to prevent the complications.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第20期2065-2068,共4页
Orthopedic Journal of China
关键词
股骨转子间骨折
失血量
围手术期
老年
：intertrochanteric fracture, the blood loss, perioperative period, the aged
