老年股骨粗隆间骨折围术期隐性失血量的临床分析

A clinical analysis of hidden blood loss in elderly patients with intertrochanteric fracture of femur during perioperative period

目的 分析影响老年股骨粗隆间骨折(IFF)围术期隐性失血量的相关因素。方法 选取医院接受手术治疗的110例老年IFF患者为研究对象,记录患者入院第1天与术后第3天的隐性失血量情况,并设计基线资料填写表,记录患者相关基线资料,比较不同资料特征患者隐性失血量,分析可能影响老年IFF围术期隐性失血量的相关因素。结果 110例老年IFF患者围术期平均总失血量为(913.62±169.84) mL,术中显性失血量为(254.91±57.83) mL,隐性失血量为(795.20±128.75) mL;合并基础疾病、骨折A3型、髓内固定的老年IFF患者围术期隐性失血量高于无合并基础疾病、骨折A1型和A2型、髓外固定的患者,差异有统计学意义(P<0.05);其他不同特征老年IFF患者围术期隐性失血量比较,差异无统计学意义(P>0.05);多元线性回归分析结果显示,合并基础疾病、骨折A3型、髓内固定均是老年IFF患者围术期隐性失血量多的影响因素(P<0.05)。结论 合并基础疾病、骨折A3型、髓内固定均是老年IFF患者围术期隐性失血量多的影响因素。

Objective To analyze the related factors of hidden blood loss in elderly patients with intertrochanteric fracture of femur(IFF) during perioperative period. Methods A total of 110 elderly patients with IFF who received surgical treatment were selected as research subjects, the hidden blood loss of patients was recorded on the first day before admission and third day after operation, the baseline data filling form was designed to record the related baseline data of patients, the hidden blood loss of patients with different characteristics of data was compared, the related factors that might affect the hidden blood loss in elderly patients with IFF were analyzed. Results Of 110 elderly patients with intertrochanteric fracture of femur, the average total perioperative blood loss was(913. 62±169.84) mL, and the preoperative hidden blood loss was(254.91±57.83) mL and the hidden blood loss was(795.20±128.75) mL;the hidden blood loss of elderly patients with IFF combined with underlying diseases, type A3 of fracture, intramedullary fixation and general anesthesia was higher than that of patients without underlying diseases, type A1 and A2 of fracture, extramedullary fixation, the differences were statistically significant(P<0.05);there was no statistically significant difference in the amount of hidden blood loss in elderly IFF patients with differed characteristics during perioperative period(P>0.05);the results of multiple linear regression analysis showed that combining with underlying diseases, type A3, intramedullary fixation were the influencing factors of more hidden blood loss in elderly patients with IFF(P<0.05). Conclusion Combining with underlying diseases, type A3 of fracture,and intramedullary fixation are the influencing factors of hidden blood loss in elderly patients with IFF.