性别及内固定方式对老年股骨转子间骨折患者围术期隐性失血量的影响

Effect of gender and internal fixation method on perioperative hidden blood loss in elderly patients with intertrochanteric fractures

目的探究性别及内固定方式对老年股骨转子间骨折患者围术期隐性失血量的影响。方法选取2014年5月至2016年7月本院收治的80例老年股骨转子间骨折患者，根据内固定方式不同将其分为A、B两组。其中A组45例行动力髋螺钉治疗，B组35例行股骨近端防旋髓内钉治疗。观察比较两组患者围术期的隐性失血量及其与内固定方式和性别的相关性。结果A组患者隐性失血量[（338．5±23．7）ml]明显低于B组[（445．8±16．2）ml]，差异有统计学意义俨〈0．05）。组内比较，A、B组男性患者隐性失血量均低于女性患者，差异均有统计学意义（P〈0．05）。A组患者显性失血量[（197．2±17．9）m1]高于B组[（125．7±13．1）ml]，总失血量[（535．8±16．7）ml]低于B组[（572．2±15．5）ml]，差异均有统计学意义（P〈0．05）。性别（OR=3．027，P=0．040）及内固定方式（OR=2．323，P=O．043）与隐性失血呈相关性，差异有统计学意义（P〈0．05）。结论老年男性患者隐性失血量少于女性患者，行动力髋螺钉治疗患者隐性失血量少于行股骨近端防旋髓内钉治疗患者，性别及内固定方式与老年股骨转子间骨折患者围术期隐性失血量具有密切联系。

Objective To explore the effect of gender and internal fixation method on perioperative hidden blood loss in elderly patients with intertrochanteric fractures. Methods 80 elderly patients with intertrochanteric fractures in our hospital from May 2014 to July 2016 were selected and divided into group A and group B according to different internal fixation methods. 45 cases in the group A were treated by dynamic hip screw, while 35 cases in the group B were treated by proximal femoral nail anti-rotation. Observed the hidden blood loss at the per^operative period of the two groups and its correlation with the internal fixation method and the gender. Results The amount of hidden blood loss of the group A [（338.5±23.7）ml] was significantly lower than that of the group B [（445.8±16.2） ml], with statistically significant difference （P〈0.05）. The amount of hidden blood loss of the male patients was significantly lower than that of the female patients in both two groups, with statistically significant differences （P〈0.05）. The amount of dominance blood loss of the group A [（197.2±17.9）ml] was higher than that of the group B [（125.7±13.1）ml], and the total amount of blood loss of the group A [（535.8±16.7）ml] was lower than that of the group B [（572.2±15.5）ml], with statistically significant differences （P〈0.05）. The gender （OR=3.027,P=0.040） and the internal fixation method （OR=2.323, P=0.043） were correlated with hidden blood loss, with statistically significant differences （P〈0.05）. Conclusions The hidden blood loss of the elderly male patients was less than that of the female patients, and the hidden blood loss of the patients treated by dynamic hip screw was less than that of the patients treated by proximal femoral nail anti-rotation. The gender and the internal fixation method were closely related to the hidden blood loss at the per^operative period of elderly patients with intertrochanteric fractures.