摘要
目的探讨老年股骨转子间骨折患者围术期输血相关危险因素,为临床合理输血与避免输血相关并发症提供理论指导。方法回顾性分析自2010年9月至2016年12月收治的167例老年股骨转子间骨折患者的临床资料。所有患者均接受手术内固定治疗。根据围术期是否输血,将患者纳入输血组90例与非输血组77例。比较两组患者的年龄、性别、体质量指数、手术方式、术前血红蛋白水平、手术时间、术中失血量、骨折分型,采用Logistic回归分析输血相关危险因素。结果年龄、体质量指数、手术方式、术前血红蛋白水平、手术时间、术中失血量、骨折分型与老年股骨转子间骨折患者围术期输血相关(P<0.05)。术前血红蛋白水平<110 g/L、手术时间≥60 min、术中失血量≥500 ml、骨折类型复杂(A2型+A3型)是影响老年股骨转子间骨折患者围术期输血的独立危险因素(P<0.05)。结论老年股骨转子间骨折患者围术期输血的独立危险因素有术前血红蛋白水平<110 g/L、手术时间≥60 min、术中失血量≥500 ml、骨折类型复杂(A2型+A3型)。因此,术前血红蛋白水平<110 g/L与骨折类型复杂(A2型+A3型)的患者应在术前充足备血,术中尽量缩短手术时间并减少术中失血量,术后及时复查血常规以纠正贫血。
Objective To investigate the risk factors of perioperative blood transfusion in elderly intertrochanteric fracture,and to provide theoretical guidance for clinical and rational blood transfusion. Methods A retrospective study was performed on 167 cases of elderly patients with intertrochanteric fracture who were admitted from September 2010 to December 2016. All the patients received treatment of internal fixation. According to the red cells transfusion during the perioperative period,patients were divided into the transfusion group( n = 90) and the non-transfusion group( n = 77). The age,gender,body mass index( BMI),surgical method,preoperative hemoglobin level,operation time,blood loss volume,fracture type were compared between the two groups,the risk factors of blood transfusion were analyzed by multivariate Logistic regression analysis. Results Age,BMI,surgical method,preoperative hemoglobin level,operation time,intraoperative blood loss,fracture type were related with perioperative blood transfusion in elderly intertrochanteric fracture( P〈0. 05). The preoperative hemoglobin level was less than 110 g/L,operation time was longer than 60 minutes,blood loss volume was more than 500 ml,complicated fracture type( type A2 and type A3) were the independent risk factors of perioperative blood transfusion in elderly intertrochanteric fracture( P〈0. 05). Conclusion The independent risk factors of perioperative blood transfusion in elderly intertrochanteric fracture were preoperative hemoglobin level was less than 110 g/L,operation time was longer than 60 minutes,blood loss volume was more than 500 ml and complicated fracture type( type A2 and type A3). Therefore,for the patients with complicated fracture type( type A2 and type A3) whose hemoglobin level was less than 110 g/L,the adequate preoperative blood preparation should be made,operation time should be shorten,blood loss should be reduced,postoperative blood routine examination should be made and anemia should be corrected in t
出处
《临床军医杂志》
CAS
2017年第10期1061-1063,共3页
Clinical Journal of Medical Officers
基金
承德市科技局科技项目(201606A072)
关键词
老年
股骨转子间骨折
围术期
输血
危险因素
Eldly
Intertrochanteric fracture
Perioperative period
Blood transfusion
Risk factor