摘要
目的探讨股骨近端防旋型髓内钉(PFNA)治疗股骨粗隆间骨折术中髓内损伤与围手术期失血的关系。方法回顾性分析2011年1月至2014年3月在本组行PFNA内固定手术治疗股骨粗隆间骨折患者63例,根据术中所使用的髓内钉型号分为10号组:31例;11号组:32例。通过Gross方程及Nadle计算方法得出患者失血总量及隐性失血量。结果 10号组平均失血总量为(746±66)ml,11号组平均总失血量为(798±70)ml,两组比较差异有统计学意义(P<0.05);10号组平均显性失血量为(106±11)ml,11号组平均显性失血量为(104±9)ml,两组比较差异无统计学意义(P>0.05);10号组平均隐性失血量为(640±68)ml,11号组平均隐性失血量为(694±67)ml,两组比较差异有统计学意义(P<0.05)。结论隐性失血是PFNA术围手术期失血的主要因素,PFNA型号大小可能是股骨粗隆间骨折髓内钉内固定术术后隐性出血的一个重要因素。
Objective To explore the relationship between intramedullary injury caused by proximal femoral nail anti-rotation（ PFNA） and perioperative blood loss in the treatment for intertrochanteric femoral fractures. Methods A retrospectively analysis was conducted on 63 patients of intertrochanteric femoral fractures who underwent the close reduction and internal fixation with PFNA from Jan 2011 to Mar 2014. All the cases were divided into 10 D group（ 31 cases） and 11 D group（ 32cases）according to the size of PFNA. The total blood loss and occult blood loss were calculated by Gross formulae and Nadle calculation method. Results The mean total blood loss was（ 746 ± 66） ml in 10 D group and（ 798 ± 70） ml in 11 D group respectively. The difference between the two groups was significant（ P〉0. 05）. The mean dominant blood loss in 10 D group was（ 106 ± 11） ml and（ 104 ± 9） ml in 11 D group,and the difference between the two groups was not significant（ P〈0. 05）. The mean occult blood loss of11 D group was significantly more than 10 D group [（ 640 ± 68） ml vs（ 694 ± 67） ml,P〈0. 05].Conclusion Occult blood loss is a main part of perioperative blood loss in PFNA internal fixation surgery;for those cases with intertrochanteric femoral fracture,the size of PFNA might be a key factor to the occult blood loss in the perioperative period.
出处
《中华关节外科杂志（电子版）》
CAS
2015年第4期18-21,共4页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
骨钉
内固定器
髋骨折
围手术期医护
失血
手术
骨折固定术
髓内
Bone nails
Internal fixators
Hip fractures
Perioperative care
Blood loss
surgical
Fracture fixation
intramedullary
