老年髋部骨折合并慢性血吸虫病患者围手术期凝血功能变化的临床研究

A Clinical Study on the Perioperative Coagulation function in the Elderly Intertrochanteric Fracture Patients with Chronic Schistosomiasis

目的:探讨合并慢性血吸虫病的老年股骨粗隆间骨折患者围手术期肝功能及凝血功能的变化。方法:2015年9月-2018年6月,我院共治疗老年股骨粗隆间骨折260例,其中合并慢性血吸虫病的患病组患者115例,未合并慢性血吸虫病的正常组患者145例,分析和比较术前术后肝功能指标、凝血功能指标的变化。结果:两组患者术前腹部腹水量(ABD),血清白蛋白(ALB),胆红素(TBIL),丙氨酸转氨酶(ALT),凝血酶原时间(PT),纤维蛋白原定量(FIB)均存在显著性差异。术后两组患者的腹部腹水量(ABD),胆红素(TBIL),丙氨酸转氨酶(ALT),凝血酶原时间(PT),活化部分凝血活酶时间(APTT)、纤维蛋白原定量(FIB)均存在显著性差异。药物调整后患病组肝功能和凝血功能显著改善。结论:与正常组相比,合并慢性血吸虫病的老年股骨粗隆间骨折患者,围手术期术前及术后肝功能、凝血功能均存在明显异常。通过术前药物治疗及围手术期的药物维持,患病组的肝功能及凝血功能指标有明显好转,但术后肝功能、凝血功能仍需要积极的进行治疗干预。同时,术后抗凝药物治疗需要谨慎。

Objective:To investigate the changes of perioperative liver coagulation function in the elderly intertrochanteric fracture patients with chronic schistosomiasis.Methods:A retrospective review of 260 elderly intertrochanteric fracture patients with chronic schistosomiasis treated by PFNA between September 2015 and June 2018(115 cases with chronic schistosomiasis).We analyzed and compared the changes of lver and coagulation function during perioperative period.Results:Compared with the normal group,there were obvious abnormalities in preoperative liver function and coagulation function in patients with chronic schistosomiasis group,such as ABD,TBIL,ALT,PT,FIB.Liver and coagulation function improved obviously through preoperative drug therapy and perioperative drug maintenance.Conclusions:In elderly intertrochanteric fracture patients combined with chronic schistosomiasis,liver function and coagulation function are obvious abnormalities during perioperative period.It is very important to adjust the liver and coagulation function in these patients positively.Meanwhile,we should pay more attention to use the postoperative anticoagulant drugs in these patients.