病情与外科治疗方案对股骨颈骨折患者围术期失血影响的研究

The influence of disease and surgical treatment on perioperative blood loss of patients with femoral neck fracture

目的探究病情与外科治疗方案对股骨颈骨折患者围术期失血影响研究。方法选择2013年9月~2015年12月来我院就治股骨颈骨折患者102例,根据病情和外科治疗方案分为观察1组(26例)为Garden I^II型行螺钉固定组,2组(11例)为Garden III^IV型行螺钉固定组,3组(12例)为Garden I^II型行关节置换术组,4组(53例)为Garden III^IV型行关节置换术组。比较四组术前隐性失血量和术前血红蛋白水平,比较患者失血量指标。结果外科手术方式相同时,观察1组和2组比较,术前隐性失血量多于2组,术前血红蛋白水平低于2组,观察3组术前隐性失血量多于4组,术前血红蛋白水平低于4组(P<0.05);病情相同时,观察1组术前隐性失血量少于3组,术前血红蛋白水平高于2组,观察2组术前隐性失血量少于4组,术前血红蛋白水平高于4组(P<0.05);外科手术方式相同时,观察1组四项失血量指标少于2组,3组四项失血量指标失血量少于4组(P<0.05);病情相同时,观察1组四项失血量指标少于观察2组,观察2组四项失血量指标少于2组(P<0.05);Garden I^II患者四项失血量指标和Garden III^IV患者无明显统计学差异(P>0.05);螺钉固定组患者的四项失血量指标明显少于关节置换术患者比较(P<0.05)。结论患者的病情中骨折类型影响患者的术前隐性失血量,患者外科手术治疗方式影响患者四项失血量,值得临床关注。

Objective To explore the influence of disease and surgical treatment on perioperative blood loss of patients with femoral neck fracture. Methods 102 patients with femoral neck fracture were selected in our hospital from September 2013 to December 2015.According to the disease and surgical treatment options, they were divided into the observation group 1 （26 cases） for Garden I-II type screw fixation group, the observation group 2 （11 cases） for Garden III-IV type screw fixation group, the observation group 3 （12 cases） for Garden I-II type hip arthroplasty group, and the observation group4 （53 cases） for Garden III-IV type for hip arthroplasty group. Preoperative occult blood loss and preoperative hemoglobin level were compared between the four groups, and the four blood loss indices were compared. Results In the same way surgery, the preoperative occult blood loss of groupl was more than that of group2, level of hemoglobin in group 1 was lower than that in the group 2, preoperative occult blood loss of group 3 was more than that of the observation group 4, and the preoperative hemoglobin level of group 3 was lower than that in the group 4 （P 〈 0.05）. In the same condition, the preoperative occult blood loss of group 1 was lower than that of group3, level of hemoglobin in the 1 groups was higher than that in the group 3, preoperative occult blood loss of group 2 was lower than that of the observation group 4, and the preoperative hemoglobin level of group 2 was higher than that in the group 4 （P〈0.05）. At the same time of surgical operation, the four indexes of blood loss in group 1 was less than that in group2. The blood loss of group 3 was less than 4 groups （P〈0.05）.At the Same time, the four indexes of blood loss in group 1 was less than that in group3. The four indexes of blood loss in group 3 was less than that of group 4 （P 〈 0.05）. There were no significant statistical differences in the four indexes of blood loss between Garden Ⅰ～Ⅱ patients and Garden Ⅲ-Ⅳ patients （P〉0.05）. Four indexes of blood loss in patients with screw fixation group was significantly less than that of joint replacement patients （P 〈 0.05）. Conclusion The type of fracture can affect the preoperative occult blood loss, and the patient＇s surgical procedures can affect the patient＇s four blood loss, which demands sufficient clinical attention.