髋部骨折治疗中隐性失血的研究进展

Research progress of hidden blood loss in treatment of hip fracture

髋部骨折是临床中常见的骨折类型,包括股骨颈骨折、股骨粗隆间骨折和股骨粗隆下骨折等类型,多见于老年骨质疏松患者。为预防长期卧床导致的并发症、降低病死率、改善生活质量,髋部骨折以手术治疗为主。随着手术器械、技术的进步,髋部骨折可通过微创手术在短时间和低出血量下完成。但近年来,许多临床医师发现髋部骨折尤其是粗隆间骨折发生后,血红蛋白下降幅度与术中出血量不成比例,提示围手术期除术中可见出血外,还有大量隐性失血。失血过多可能导致患者严重贫血,若不能及时发现并做相应处理,可能导致相关并发症的出现,影响预后甚至导致患者死亡。本文就目前髋部骨折隐性失血研究进展作一综述。

Hip fracture is a common type of fracture in the clinic,which occurs more common in elderly patients with osteoporosis,including femoral neck fractures,intertrochanteric fractures and femoral subtrochanteric fractures. Hip fractures are mainly treated with surgery to prevent complications caused by prolonged bed rest,and the surgery could reduce mortality and improve quality of life. With the advancement of surgical instruments and techniques,most hip fractures can be treated by minimal invasive surgery within a short time and with less bleeding.However,in recent years,many clinicians have found that after the occurrence of hip fractures,especially intertrochanteric fractures,the decrease in hemoglobin is not proportional to the amount of intraoperative blood loss,suggesting that there is a large amount of hidden blood loss in addition to bleeding during the perioperative period. A large number of hidden blood loss may lead to severe anemia in patients. If it is not detected and treated in time,it may cause related complications,affect the prognosis and even lead to death. This article reviews the current research progress of hidden blood loss in hip fractures.