摘要
目的探讨髓内钉固定治疗股骨干骨折患者围手术期的总失血量、显性失血量、隐性失血量等，以期为临床提供相关资料。方法回顾性分析2010年7月至2016年5月采用髓内钉固定治疗的41例股骨干骨折患者资料。男30例，女11例；年龄为19～85岁，平均55．7岁；左侧19例，右侧22例；骨折AO分型：32-A型21例，32．B型13例，32．c型7例。受伤至手术时间为12h至8d，平均3．7d。根据年龄不同分为2组：年轻组23例，年龄〈65岁；老年组18例，年龄365岁。对患者术前、术后血常规、术中及术后失血量进行分析，比较两组患者的失血量。结果41例患者平均总失血量为2076．8mL，平均隐性失血量为1796．5mL，隐性失血比例平均为86．5％。年轻组患者总失血量和隐性失血量平均分别为（1917．5±548．1）、（1641．6±468．1）mL，显著低于老年组患者[（2280．3±436．9）、（1994．5±408．0）mL]，差异均有统计学意义（P〈0．05）。而两组患者的显性失血量比较差异无统计学意义（P〉0．05）。年轻组患者的隐胜失血比例平均为85．6％，老年组患者隐性失血比例平均为87．5％。结论隐性失血是股骨干骨折患者围手术期失血的主要组成部分，其中老年患者隐性失血量更多，更应重视。
Objective To analyze the total blood loss, obvious blood loss and hidden blood loss during intramedullary nailing of femoral shaft fractures. Methods A retrospective study was conducted of the clinical data of 41 patients with femoral shaft fracture who had been treated with intramedullary nailing from July 2010 to May 2016. They were 30 men and 11 women, from 19 to 85 years of age （average, 55.7 years）. Involved were 19 sides and 22 right ones. By AO classification, type 32-A was in 21 cases, type 32-B in 13 ones, and type 32-C in 7 ones. The intervals from injury to surgery averaged 3.7 days （range, from 12 hours to 8 days）. They were divided into 2 groups according to age. In the young group of 〈 65 years, there were 23 cases; in the elderly group of t〉65 years, there were 18 ones. Comparisons were made between the 2 groups regarding preoperative and postoperative blood routine, intraoperative and postoperative blood loss. Results The total blood loss of the 41 patients averaged 2, 076.8 mL and the hidden blood loss 1, 796.5 mL, yielding a proportion of average hidden blood loss of 86.5%. In the young group, the total blood loss averaged 1,917.5 ± 548.1 mL and the hidden blood loss 1,641.6 ± 468.1 mL. In the elderly group, the total blood loss averaged 2, 280.3 ± 436.9 mL and the hidden blood loss 1,994.5 ± 408.0 mL. The differ- ences between the 2 groups were statistically significant（ P 〈 0. 05） . However, there was no significant dif- ference between the 2 groups in the obvious blood loss （ P 〉 0. 05）. The proportion of average hidden blood loss was 85.6% in the young group and 87.5% in the elderly group. Conclusions Hidden blood loss may account for the overwhelming majority proportion of the perioperative total blood loss in patients with femoral shaft fracture undergoing intramedullary nailing. The elderly patients may be prone to more hidden blood loss.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2016年第11期961-964,共4页
Chinese Journal of Orthopaedic Trauma
关键词
股骨骨折
骨折固定术
髓内
骨钉
失血
手术
Femoral fractures
Fracture fixation, intramedullary
Bone nails
Blood loss, surgical
