安徽医药
安徽醫藥
안휘의약
ANHUI MEDICAL AND PHARMACEUTICAL JOURNAL
2015年
4期
709-711
,共3页
股骨近端防旋髓内钉%股骨转子间骨折%围手术期%隐性失血
股骨近耑防鏇髓內釘%股骨轉子間骨摺%圍手術期%隱性失血
고골근단방선수내정%고골전자간골절%위수술기%은성실혈
proximal femoral nail anti-rotation%intertrochanteric fracture%perioperative period%hidden blood loss
目的:对采取股骨近端防旋髓内钉( PFNA)内固定方法治疗的老年股骨转子间骨折的围术期隐性出血量进行分析,为临床处理提供必要的数据支撑。方法回顾性分析该院在2010年3月至2014年3月,采取PFNA治疗的80例股骨转子间骨折患者,其中男43例,女37例,平均年龄77.8岁。使用Gross方程,根据身高、体重和手术前后的红细胞比容( HCT)变化,计算围手术期隐性失血量。结果80例患者中围手术期未输血的62例,男34例,女28例;平均年龄78.2岁;平均手术时间43.71 min;术中失血及术后引流量116.30 mL。术前血红蛋白( Hb)平均111.3 g· L-1,术后84.6 g· L-1,降低了26.7 g· L-1;术前红细胞比容(HCT)平均36.27%,术后27.13%,降低了9.14%。采取输血支持的18例,男9例,女9例;平均年龄76.5岁;平均手术时间46.42 min;术中失血及术后引流量共111.24 mL;平均输血量574.22 mL。术前Hb平均98.2 g· L-1,术后95.7 g· L-1,降低了2.5 g· L-1;术前HCT平均29.87%,术后29.15%,降低了0.72%。按Gross方程计算,两组围手术期失血量分别为763.07 mL和631.68 mL,其中隐性失血量分别占84.76%和82.39%。结论 PFNA内固定治疗老年股骨转子间骨折患者围手术期隐性失血量较多,临床上应特别重视并严格注意术后患者生命体征的变化,以减少并发症的发生。
目的:對採取股骨近耑防鏇髓內釘( PFNA)內固定方法治療的老年股骨轉子間骨摺的圍術期隱性齣血量進行分析,為臨床處理提供必要的數據支撐。方法迴顧性分析該院在2010年3月至2014年3月,採取PFNA治療的80例股骨轉子間骨摺患者,其中男43例,女37例,平均年齡77.8歲。使用Gross方程,根據身高、體重和手術前後的紅細胞比容( HCT)變化,計算圍手術期隱性失血量。結果80例患者中圍手術期未輸血的62例,男34例,女28例;平均年齡78.2歲;平均手術時間43.71 min;術中失血及術後引流量116.30 mL。術前血紅蛋白( Hb)平均111.3 g· L-1,術後84.6 g· L-1,降低瞭26.7 g· L-1;術前紅細胞比容(HCT)平均36.27%,術後27.13%,降低瞭9.14%。採取輸血支持的18例,男9例,女9例;平均年齡76.5歲;平均手術時間46.42 min;術中失血及術後引流量共111.24 mL;平均輸血量574.22 mL。術前Hb平均98.2 g· L-1,術後95.7 g· L-1,降低瞭2.5 g· L-1;術前HCT平均29.87%,術後29.15%,降低瞭0.72%。按Gross方程計算,兩組圍手術期失血量分彆為763.07 mL和631.68 mL,其中隱性失血量分彆佔84.76%和82.39%。結論 PFNA內固定治療老年股骨轉子間骨摺患者圍手術期隱性失血量較多,臨床上應特彆重視併嚴格註意術後患者生命體徵的變化,以減少併髮癥的髮生。
목적:대채취고골근단방선수내정( PFNA)내고정방법치료적노년고골전자간골절적위술기은성출혈량진행분석,위림상처리제공필요적수거지탱。방법회고성분석해원재2010년3월지2014년3월,채취PFNA치료적80례고골전자간골절환자,기중남43례,녀37례,평균년령77.8세。사용Gross방정,근거신고、체중화수술전후적홍세포비용( HCT)변화,계산위수술기은성실혈량。결과80례환자중위수술기미수혈적62례,남34례,녀28례;평균년령78.2세;평균수술시간43.71 min;술중실혈급술후인류량116.30 mL。술전혈홍단백( Hb)평균111.3 g· L-1,술후84.6 g· L-1,강저료26.7 g· L-1;술전홍세포비용(HCT)평균36.27%,술후27.13%,강저료9.14%。채취수혈지지적18례,남9례,녀9례;평균년령76.5세;평균수술시간46.42 min;술중실혈급술후인류량공111.24 mL;평균수혈량574.22 mL。술전Hb평균98.2 g· L-1,술후95.7 g· L-1,강저료2.5 g· L-1;술전HCT평균29.87%,술후29.15%,강저료0.72%。안Gross방정계산,량조위수술기실혈량분별위763.07 mL화631.68 mL,기중은성실혈량분별점84.76%화82.39%。결론 PFNA내고정치료노년고골전자간골절환자위수술기은성실혈량교다,림상상응특별중시병엄격주의술후환자생명체정적변화,이감소병발증적발생。
Objective To analyze the perioperative hidden blood loss during treatment of the intertrochanteric fracture in elderly pa-tients with proximal femoral nail anti-rotation( PFNA) so as to provide necessary data for clinical treatment.Methods A retrospective case series of 80(male 43,female 37)patients with an average age of 77.8 years,operated between March 2010 and March 2014 was re-viewed.The perioperative hidden blood loss was calculated by Gross formula,on according to the changes of height,weight and erythro-cyte hematocrit(HCT)before and after surgery.Results There were 62 cases(male 34,female 28)in the non-blood transfusion group with mean age of 78.2 years.The mean hemoglobin(Hb)value pre-op was 111.3 g· L-1 and post-op 84.6 g· L-1(decrease 26.7 g· L-1),and the mean HCT value was 36.27%preoperatively and 27.13% postoperatively(decrease 9.14%),respectively.There were 18 patients(male 9,female 9)in the blood transfusion group with mean age of 76.5 years.The mean blood transfusion volume was 574. 22 mL.The mean Hb value was 98.2 g· L-1 preoperatively and 95.7 g· L-1 postoperatively(decrease 2.5 g· L-1 ),the mean HCT value was 29.87%and 29.15%( decrease 0.72%) ,respectively.The calculated mean total blood loss was 631.38 mL with observed loss during operation and drainage 111.24 mL.The hidden blood loss was 763.07 mL in non-transfusion group and 631.68 mL in trans-fusion group,which was about 6 times greater than the observed blood loss,and occupied about 80% of the total blood loss volume. Conclusion The amount of perioperative hidden blood loss of intertrochanteric fracture in elderly patients with PFNA treatment is more,we should pay special attention to the vital signs of postoperative patients,so as to reduce the complications and help them safety through perioperative.