髋关节置换术在治疗老年股骨颈骨折中隐性失血的分析

To analysis the hidden hemorrhage of hip arthroplasty in treating elderly patients with femoral neck fracture

目的探讨半髋关节置换术和全髋关节置换术对老年股骨颈骨折患者隐性失血量的影响。方法选择2015年1月至2017年11月行髋关节置换的老年股骨颈骨折患者50例为研究对象,依据术式分为全髋关节置换组、半髋关节置换组。监测术前、术后血红蛋白(Hb)、红细胞比容(Hct)变化、术后引流量等,计算失血总量、显性失血量、隐性失血量,并进行比较。结果全髋关节置换组隐性失血量多于半髋关节置换组,差异有统计学意义(P<0.05);2组患者失血总量、显性失血量、隐性失血量/失血总量比较,差异无统计学意义(P>0.05);全髋关节术后置换组Hct下降值、Hb下降值较半髋关节置换组高,差异有统计学意义(P<0.05)。结论老年股骨颈骨折行全髋置换术隐性失血量多于半髋置换术,应引起医生足够的重视。

Objective To explore the effect half hip arthroplasty and total hip arthroplasty in elderly patients with femoral neck fracture on hidden hemorrhage.Methods A total of 50 elderly with femoral neck fracture with hip arthroplasty were selected from January 2015 to November 2017 and divided into total hip arthroplasty group and half hip arthroplasty group.Monitor the changes of hemoglobin（Hb）,hematocrit（Hct）and postoperative drainage volume,calculate the total hemorrhage volume,dominant and hidden hemorrhage volume,and compared.Results The hidden hemorrhage volume in total hip arthroplasty group was higher than that of the half hip arthroplasty group（P0.05）.The total hemorrhage volume,dominant hemorrhage volume and the proportion of the hidden hemorrhage volume to the total hemorrhage volume had no significant differences between the two groups（P0.05）.The degrees of the Hct and Hb reduction in total hip arthroplasty group during the perioperative period decreased significantly more than those in the half hip arthroplasty group（P0.05）.Conclusion The hidden hemorrhage volume in the total hip arthroplasty in elderly femoral neck fractures is more than that of the half hip arthroplasty,doctor should pay enough attention on it.