Schatzkeer Ⅴ型胫骨平台骨折术后肢体肿胀与隐性失血量的关系

Correlation between limb swelling and hidden blood loss after operation for Schatzkeer Ⅴ tibial plateau fracture

目的分析Schatzkeer Ⅴ型胫骨平台骨折双切口术后隐性失血量对肢体肿胀程度的影响。方法对2009年3月～2011年4月在我科行Schatzkeer Ⅴ型胫骨平台骨折双切口手术的24例患者进行回顾性分析,通过围手术期血红蛋白变化来推算患者隐性失血量(HBL),再测量出术后第1～3 d的术侧胫骨平台平面肢体周径较术前相比增加值,研究术后隐性失血量与肢体周径变化的关系。结果隐性失血量对术侧下肢肢体周径变化造成明显影响(P<0.01),且Δ周径(cm)与隐性失血量呈正相关(r=0.867,P<0.01)。结论对复杂的胫骨平台骨折,尤其是Schatzkeer Ⅴ型骨折,采用内外侧双切口手术治疗后,可降低隐性失血量,对减轻切口周围肿胀有一定的作用。

Objective To analyze the influence of hidden blood loss （HBL） on the degrees of limb swelling after the double incision for Schatzkeer V tibial plateau fracture. Methods A retrospective analysis was made among 24 patients with Sehatzkeer V tibial plateau fracture who received double incision in our department from March 2009 to April 2011. Their HBL was calculated according to changes in perioperative hemoglobin. Detection was made in their average increasing value of planar limb circumference in d 1 - 3 after the operation. Pearson correlation analysis was used to study the correlation between postoperative HBL and changes in limb circumference. Results HBL significantly affected the changes in lower limb circumference （ P 〈 0.01 ） , and there was a positive correlation between these two factors （ P 〈 0.01 ）. Conclusion In the treatment of complicated tibial plateau fracture and especially Schatzkeer V fracture, there is a positive correlation between patients＇degrees of limb swelling and HBL after double incision at internal and external sides. Decreasing the HBL plays a certain role in the relieving of swelling around the incision.