髓内固定治疗老年股骨转子间骨折的失血量分析

The blood loss of intramedullary nailing for elderly patients in intertrochanteric fractures

目的对接受髓内固定治疗的老年股骨转子间骨折围手术期失血量进行临床分析,探讨失血相关因素。方法回顾性分析2009年12月至2011年12月采用股骨髓内固定治疗的73例股骨转子间骨折患者的临床资料,对患者年龄、性别、身高、体重、骨折类型、手术时间、手术前后血常规以及术中、术后出血进行分析。结果 73例患者术中平均失血72.4ml,术中均未输血,术后平均隐性失血量为312ml,占围手术期出血的81%。年龄、性别之间差异无统计学意义,手术时间不超过45min组可减少术中失血量及隐性失血量,差异有统计学意义;骨折严重组可增加术中出血量,差异有统计学意义;肥胖组可增加围手术期出血量及隐性出血量,差异有统计学意义。结论髓内固定治疗老年股骨转子间骨折术中出血量少,术后的隐性失血量较多,肥胖、严重骨折及长时间手术可以增加出血,应严格监测患者的生命体征和及时复查血常规以减少贫血导致的并发症。

Objective To analyse the perioperative blood loss after intramedullary nailing for elderly patients in intertrochanteric fractures. Methods A retrospective case series of 73 patients operated between December 2009 and December 2011 was reviewed. The age, gender, hight, weight, type of fracture, operation time, blood routine, and blood loss were analyzed. Results The mean blood loss was 72.4 ml, no blood transfusion accepted during the operation. The mean hidden blood loss was 312 ml. About 81% of the total blood loss volume was the hidden blood loss. There were significant differences in obesity group, operation time group and fracture type group in blood loss. Conclusions The volume of postoperative hidden blood loss was more than that of the blood loss during intramedullary nailing for elderly patients with intertrochanteric fractures; obesity, operation time and fracture type may be related factors which may lead to severe postoperative anemia.