摘要
目的分析Gamma钉和DHS钉治疗老年股骨转子间骨折围手术期的失血量,提高对隐性失血的认识,为临床围手术期的处理提供依据。方法回顾性分析2008年6月至2012年6月间分别采取Gamma钉治疗的38例和DHS钉治疗的32例老年股骨转子间骨折患者的临床资料,比较患者的手术时间、术中及术后出血量,对患者围手术期的显性和隐性出血情况进行评估。结果 Gamma钉治疗组平均手术时间(60.82±9.24)min,术中失血及术后引流量约100ml,DHS钉治疗组平均手术时间(78.19±8.03)min,术中失血及术后引流量约179ml,2组间差异有统计学意义(P<0.01)。按Gross方程计算,2组围手术期平均隐性出血量分别为(418.05±35.69)ml和(666.13±73.15)ml,分别占总出血量80.69%和78.79%,隐性失血量约是显性失血量的4倍。结论和DHS钉比较,Gamma钉治疗老年股骨转子间骨折手术切口虽小,但围手术期隐性失血量不能忽视。
Objective To analyze the hidden blood loss in perioperative period of femoral intertrochanteric fractures treated with Gamma nail and dynamic hips crew to enhance the clinical realization of hidden blood loss.Methods A re-trospective analysis of the 38 elderly patients with intertrochanteric fracture treated with Gamma nail and 32 elderly patients with intertrochanteric fracture treated with dynamic hip crews was taken to compare the mean operative time,intraoperative and postoperative blood loss,blood transfusion,the dominant and hidden blood loss.Results The mean operative time was(60.82±9.24) min in the Gamma nail group.The total dominant blood loss during operation and drainage was 100 ml.The mean operative time was(78.19±8.03) min in the dynamic hip screws group.The dominant blood loss during operation and drainage was 179 ml.The diffence of dominant blood loss was significant between the two groups(P<0.01).The hidden blood loss was(418.05±35.69)ml in Gamma nail group and(666.13±73.15)ml in dynamic hip screws group,which accounted for 80.69% and 78.79% of total amount of bleeding respectively.Conclusions The incision of the Gamma nail group is more smaller than that in dynamic hips crew group,however,the total blood loss of the Gamma nail group is more.The hidden blood loss in perioperative period of femoral intertrochanteric fractures with Gamma nail should be taken into at tention.
出处
《实用老年医学》
CAS
2013年第5期380-383,共4页
Practical Geriatrics
