摘要
目的观察股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折(IFF)隐性失血的特点,并分析出血的影响因素。方法回顾性分析中山市港口医院骨科2015年1月至2017年12月收治的55例老年IFF患者的临床资料,根据Gross方程计算PFNA治疗期间的隐性失血量,以隐性失血量为因变量,多元线性回归分析相关因素对隐性失血的影响。结果 PFNA手术显性、隐性及总失血量分别为(166.25±30.13)m L、(706.25±90.26)m L、(859.16±91.24)m L。隐性失血是导致PFNA围手术期失血的主要原因。单因素及多元线性分析结果显示,高血压病、伤后手术延迟、年龄、抗凝药物应用情况、骨折类型以及糖尿病是影响PFNA隐性失血的独立危险因素(P<0.05)。结论隐性失血是老年IFF患者PFNA手术失血主要原因,内固定方式、骨折类型、合并基础疾病、抗凝药物运用以及伤后手术延迟是导致PFNA隐性失血的独立危险因素。
Objective To observe the characteristics of hidden blood loss of proximal femoral nail antirotation（PFNA） treatment of senile intertrochanteric femur fractures（IFF） and analyze its influence factors. Methods The clinical data of 55 elderly IFF patients, who admitted to Department of Orthopedics of Zhongshan Port Hospital from Jan.2015 to Dec. 2017, were retrospectively analyzed. The amount of hidden blood loss during PFNA treatment was calculated according to the Gross equation, which was used as the dependent variable to analyze the effect of associated factors on hidden blood loss through multiple linear regression. Results The total amount of dominant, hidden and total blood loss in PFNA treatment were（166.25 ± 30.13） m L,（706.25 ± 90.26） m L,（859.16 ± 91.24） m L, respectively. The hidden blood loss was a major cause of perioperative blood loss of PFNA. Univariate and multivariate linear analysis showed that hypertension after injury, delayed operation, age, fracture type, application of anticoagulant drugs and diabetes were independent risk factors of hidden blood loss of PFNA（P〈0.05）. Conclusion The hidden blood loss was the main cause of blood loss in elderly IFF patients undergoing PFNA surgery. Internal fixation, fracture types, complicating underlying diseases, use of anticoagulant drugs and postoperative delay are independent risk factors for recessive blood loss in PFNA.
作者
李锐军
林浙龙
周正茂
全守尧
陈淼俭
LI Rui-jun;LIN Zhe-long;ZHOU Zheng-mao;QUAN Shou-yao;CHEN Miao-jian.(Department of Orthopedics, Zhongshan Port Hospital, Zhongshan 528447, Guangdong, CHIN)
出处
《海南医学》
CAS
2018年第10期1366-1368,共3页
Hainan Medical Journal
基金
广东省中山市科技计划项目(编号:2017A020227)
关键词
隐性失血
危险因素
股骨粗隆间骨折
股骨
骨折
Hidden blood loss
Risk factors
Intertrochanteric femur fractures （IFF）
Femur
Fracture
