摘要
目的观察股骨转子间骨折闭合复位Gamma-3内固定患者手术时股骨近端扩髓与否对失血量的影响。方法选取65岁以上股骨转子间骨折闭合复位Gamma-3内固定手术的135例患者为研究对象,所有患者分为三组。A组患者56例,插入髓内钉主钉前股骨髓腔不用扩髓器进行扩髓; B组患者18例,股骨髓腔周径窄,插入髓内钉主钉困难者需用扩髓器进行扩髓; C组患者61例,髓内钉主钉插入前主动用扩髓器进行扩髓。比较各组患者的总失血量、显性失血量、隐性失血量、手术时间等。结果 A组患者术中显性失血量为(103±27) mL,B、C组患者术中失血量分别为(124±32) mL,(145±32) mL,三组比较差异无统计学意义(P> 0. 05)。A组患者隐性失血量为(440±26) mL; B、C组患者术中失血量分别为(634±32) mL,(701±32) mL,A组与B、C组相比差异有统计学意义(P <0. 05)。A组患者总失血量为(543±32) mL; B、C组患者术中总失血量分别为(610±32) mL,(656±32) mL,A组与B、C组相比差异有统计学意义(P <0. 05)。结论在老年股骨转子间骨折闭合复位Gamma-3内固定手术中,股骨近端扩髓增加隐性和总失血量;股骨近端扩髓是Gamma-3内固定手术失血的独立危险因素。
Objective To observe the effect of reamed proximal femur on blood loss in patients with femoral intertrochanteric fracture,when conducting close reduction and Gamma-3 internal fixation.Methods 135 patients aged over 65 with intertrochanteric fractures were enrolled in the study,who underwent close reduction and Gamma-3 internal fixation.All patients were divided into three groups.56 patients were picked out as group A,whose proximal femur were not reamed before inserting Gamma-3 intramedullary nail.18 patients were chosen as group B,whose proximal femur must be reamed with a reamer before inserting Gamma-3 intramedullary nail because of narrow cavity.61 patients were divided into group C,whose proximal femur were reamed with a reamer before inserting Gamma-3 intramedullary nail,according to the operation process routine.Results The blood loss was(103±27)mL in group A and(124±32)mL and(145±32)mL in group B and C,respectively(P>0.05).The hidden blood loss of group A was(440±26)mL,and the blood loss in group B and group C was(634±32)mL,(701±32)mL(P<0.05).The total blood loss was(543±32)mL in group A and(610±32)mL and(656±32)mL in group B and C(P<0.05).Conclusion The proximal femoral reaming can increase the volume of total and hidden blood loss in old patients with intertrochanteric fracture,who are treated with close reduction and Gamma-3 internal fixation and proximal femoral reaming is an independent risk factor for blood lost.
作者
石少辉
吴国平
李茂廷
李海啸
甄雨晴
SHI Shaohui;WU Guoping;LI Maoting;LI Haixiao;ZHEN Yuqing(Department of Orthopaedic Surgey,General Aviation Hospital,Beijing 100012,China)
出处
《安徽医药》
CAS
2018年第12期2362-2365,共4页
Anhui Medical and Pharmaceutical Journal
基金
航空总医院院内课题(YJYB201707)
