摘要
目的探讨老年人股骨颈骨折空心钉内固定围手术期血红蛋白(Hb)变化原因。方法对2008年1月～2010年12月收治的98名股骨颈骨折行空心钉内固定术的老年(>60岁)患者入院时、术前及术后d1所做的血常规检验结果,以及手术时间、术中失血量、术前输液情况,了解它们对围术期患者Hb变化的影响。结果 98名患者平均手术时间(38.3±10.5)min,术中失血量(17.2±8.9)ml。平均Hb,术前输液后(113.0±15.0)g/L、术后d1(108.4±12.4)g/L均较入院时(122.3±15.4)g/L有所变化(P<0.05)。患者平均红细胞比容(Hct),入院时(38.2±5.2)%、术前(34.1±4.1)%和术后d1(34.0±3.9%)(P>0.05)。术后Hb<100 g/L的患者由入院时的9人增加至术前的18人,术后d1增加至30人(P<0.05)。5人术后d1的Hb<80 g/L,给予输血治疗。结论老年人股骨颈骨折空心钉内固定围手术期Hb下降的真实原因可能是术前输液对血液的稀释作用,并不需要即刻输血。对于入院时Hb<100 g/L的老年股骨颈骨折患者需监测围手术期Hb变化情况,积极行输血治疗,避免发生术后贫血。
Objective To investigate the reason of perioperative hemoglobin changes in the elderly patients who received eannulated screw fixation for femoral neck fracture. Methods This was a retrospective study which included 98 elderly patients （ 〉 60 years ） who received cannulated screw fixation for femoral neck fracture from Jan 2008 to Dec 2010. The hemoglobin was tested on admission, preoperatively and one day postoperatively（ dl ）respectively. Results The mean operative time was （ 38.3 ±10. 5 ） min, the mean intraoperative blood loss was （ 17.2±8.9 ） ml. The hemoglobin on admission（ 122. 3±15.4 ） g/L was significantly different from that at preoperatively （ 113.0±15.0 ） g/Land dl （ 108.4± 12. 4） g/L respectively （ P 〈 0.05 ）. The differences of the mean hematocrit on admission （ 38.2 ±5.2 ） %, preoperatively （ 34. 1±4. 1 ） % and dl （ 34.0± 3.9） % were not statistically significant （ P 〉 0. 05 ）. The number of patient whose hemoglobin was less than 100 g/L increased from 9 on admission to 18 preoperatively, and to 30 on dl, the differences were both statistically significant （ P 〈 0.05 ） respectively. The hemoglobin was less than 80 g/L, received blood transfu- sion. Conclusion The reason of perioperative hemoglobin decreasing in the elderly patients who received eannulated screw fixation for femoral neck fracture may be the dilution effect of preoperative infusion, thus these patients might not require immediate transfusion. The perioperative hemoglobin should be tested carefully in the elderly patients of femoral neck frac- tures whose hemoglobin was less than 100 g/L, so that the blood transfusion would be liberal to avoid postoperative anemia.
出处
《中国输血杂志》
CAS
CSCD
北大核心
2012年第3期198-200,共3页
Chinese Journal of Blood Transfusion
