摘要
目的研究股骨近端防旋髓内钉内固定(PFNA)治疗老年股骨粗隆间骨折术中注射氨甲环酸对围手术期隐性失血和血浆D-二聚体(D-D)水平的影响。方法 100例老年股骨粗隆间骨折病人,随机分为治疗组和对照组,每组50例。治疗组术中注射氨甲环酸2 ml,对照组术中不使用氨甲环酸。对比两组病人的围术期隐性失血量及对病人D-D等指标的影响。结果治疗组的显性失血量、隐性失血量、围术期总失血量和输血量分别为(215.26±58.37)ml、(453.06±83.01)ml、(673.75±103.42)ml和(110.53±32.46)ml;对照组分别为(218.44±62.95)ml,(608.83±92.63)ml,(822.77±115.48)ml和(231.04±25.38)ml。治疗组的隐性失血量、围术期总失血量和输血量均明显低于对照组(P<0.05);治疗组手术后1天和3天的血红蛋白(HGB)、手术后1天的D-D以及手术后3天的红细胞积压(HCT)均明显优于对照组(P<0.05),但手术后1d的HCT和手术后3天的D-D与对照组相比无显著差异(P>0.05),治疗组的并发症发生率为2%,与对照组相比,差异无统计学意义(P>0.05)。结论 PFNA术中注射氨甲环酸治疗老年股骨粗隆间骨折病人可以有效降低病人围术期的隐性失血量,同时也将稳定病人的D-D水平,为下肢深静脉血栓的预防产生了积极的影响。
Objective To investigate the effect of proximal femoral nail antirotation（PFNA） com- bined with tranexamic acid in the treatment of intertrochanteric fractures in senior patients and discuss its influence on the perioperative recessive blood loss and plasma D-dimer（D-D） of patients. Methods 100 cases with intertrochanteric fractures selected were randomly divided into treatment group and control group ,50 cases in each group. In the treatment group ,2 ml of tranexamic acid was used while not in the control group. Then the indices including perioperative recessive blood loss and plasma D-dimer（D-D） of the two groups were compared. Results The dominant blood loss,recessive blood loss,perioperative total blood loss and transfused blood in the treatment group were（215.26 ±58.37 ）ml, （453.06 ±83.01 ）ml, （673.75 ±103.42 ） ml and（ 110.53 ±32.46） ml,respeetively;while in the control group were（ 218.44 ±62.95 ） ml, （608.83 ±92.63 ） ml, （ 822.77 ±115.48 ） ml and （ 231.04 ±25.38 ） ml, respectively. The last three indices in the treatment group were significantly lower than those of in the control group（ P 〈 0.05 ）. HGB at 1 day and 3 days after operation, D-D at 1 day after operation and postoperative HCT at 3 days af- ter operation in the treatment group were significantly better than those of in the control group（ P 〈 0.05 ）. However, there was no significant difference in HCT at 1 day after operation and D-D at 3 days after opera- tion（P 〉 0.05 ）. Also, the complication rate in the treatment group was 2% , which was no significant difference compare with the control group （ P 〉 0.05 ）. Conclusion PFNA combined with tranexamic acid is very effective in the treatment of intertrochanteric fractures towards senile patients in the term of reduc- ing the perioperative recessive blood loss and stabilizing the D-D level to prevent positively the deep ve- nous thrombosis of patients.
作者
刘敏
张文平
罗鹏
高磊
犹怀勇
LIU Min;ZHANG Wenping;LUO Peng(Department of Orthopedics,Cangxi People＇s Hospital,Sichuan,Cangxi 628400,China)
出处
《临床外科杂志》
2018年第8期598-601,共4页
Journal of Clinical Surgery
关键词
股骨近端防旋髓内钉
氨甲环酸
股骨粗隆间骨折
隐性失血
proximal femoral nail antirotation
Tranexamic acid
intertrochanteric fracture
recessive blood loss
