CAJ | 학술논문

　　目的探讨围术期输血治疗对老年股骨粗隆间骨折隐性失血量的影响，为临床治疗及输血指征的选择提供必要的参考依据。方法回顾性分析2010年3月至2011年10月采用股骨近端防旋髓内钉（PFNA）内固定治疗的176例老年股骨粗隆间骨折患者的临床资料，按围术期是否进行过输血治疗分为输血组（56例）及未输血组（120例），对两组术前、术后血常规以及术中、术后出血等进行分析，对两组患者围术期的隐性出血量进行评估。结果输血组患者平均隐性失血量为353mL，占总失血量比例为83．1％，未输血组患者平均隐性失血量为427mL，占总失血量比例为84．6％。两组平均隐性失血量相比差异有统计学意义（P＜0．05），平均隐性失血量占总失血量比例，两组比较无统计学意义（P＞0．05）。结论围术期输血治疗并不能降低老年粗隆间骨折的隐性失血量占总失血量的比例，术后应根据红细胞压积及血红蛋白量的变化，合理选择输血治疗，减少并发症的产生。
　　목적탐토위술기수혈치료대노년고골조륭간골절은성실혈량적영향，위림상치료급수혈지정적선택제공필요적삼고의거。방법회고성분석2010년3월지2011년10월채용고골근단방선수내정（PFNA）내고정치료적176례노년고골조륭간골절환자적림상자료，안위술기시부진행과수혈치료분위수혈조（56례）급미수혈조（120례），대량조술전、술후혈상규이급술중、술후출혈등진행분석，대량조환자위술기적은성출혈량진행평고。결과수혈조환자평균은성실혈량위353mL，점총실혈량비례위83．1％，미수혈조환자평균은성실혈량위427mL，점총실혈량비례위84．6％。량조평균은성실혈량상비차이유통계학의의（P＜0．05），평균은성실혈량점총실혈량비례，량조비교무통계학의의（P＞0．05）。결론위술기수혈치료병불능강저노년조륭간골절적은성실혈량점총실혈량적비례，술후응근거홍세포압적급혈홍단백량적변화，합리선택수혈치료，감소병발증적산생。
Objective To explore perioperative blood transfusion treatment for elderly intertrochanteric frac-ture hidden blood loss ,providing the necessary reference for the clinical treatment and transfusion indications choice . Methods From march 2010 to October 2011 ,analysis 176 cases of elderly intertrochanteric fracture datas ,who treat-ment by anti-rotation of the proximal femur intramedullary nail (PFNA) .According to the perioperative was a blood transfusion therapy forblood transfusion group (n=56) and without blood transfusion group(120 cases) ,analysis of the preoperative and postoperative blood count ,intraoperative and postoperative bleeding ,to evaluate the hidden hem-orrhage between two groups .Results Blood transfusion patients average hidden hemorrhage was 353 ml ,the ratio was 83 .1% .No blood transfusion patients average hidden hemorrhage was 427 mL ,the ratio was 84 .6% .Two groups of average hidden hemorrhage ,there was statistically significant difference between two groups (P<0 .05) . the ratio between two groups was statistically significant difference (P> 0 .05) .Conclusion Perioperative blood transfusion treatment couldn't reduce the hidden hemorrhage with elderly intertrochanteric fracture .Postoperative should be based on red blood cell press and the amount of hemoglobin ,reasonable choice of blood transfusion treat-ment ,reduce the complications of produce .