老年转子间骨折股骨近端防旋髓内钉治疗术中体温干预对隐性失血的影响

Effect of body temperature intervention on occult hemorrhage in elderly patients with intertrochanteric fracture treated with PFNA

目的:老年转子间骨折行股骨近端防旋髓内钉(PFNA)治疗患者运用复合保温措施干预对术中及术后隐性失血量的影响。方法:选择诊断股骨转子间骨折并行PFNA治疗的老年患者90例,随机分为两组,每组各45例,分为保温干预组和常规处理组。常规处理组不做特别干预,而保温干预组在常规处理的基础上,运用可控式加温毯,输入液体预热加温,手术室环境温度控制等措施。记录两组手术前后的鼻咽温度变化情况、术中出血量及术后引流量,术前、术后血红蛋白变化情况,以及计算隐性失血量。结果:保温干预组的平均体温均高于常规处理组,差异有统计学意义(P<0.05);隐性失血量少于常规处理组,差异有统计学意义(P<0.05)。复合保温组的术后血红蛋白水平高于常规处理组,差异有统计学意义(P<0.05)。结论:老年转子间骨折行PFNA治疗运用复合保温干预措施能有效减少患者的隐性失血量。

Objective To study the effect of compound thermal insulation intervention on intraoperative and postoperative recessive blood loss in the treatment of senile intertrochanteric fracture with PFNA.Method A total of 90 elderly patients with femoral intertrochanteric fracture diagnosed in our hospital and treated with PFNA were randomly divided into two groups,with 45 cases in each group,which were divided into heat preservation intervention group and routine treatment group.The routine treatment group did not do special intervention,while the insulation intervention group used controllable heating blanket,input liquid preheating and heating,operating room ambient temperature control and other measures on the basis of routine treatment.The changes of nasopharyngeal temperature before and after operation,the amount of intraoperative bleeding and postoperative drainage,the changes of hemoglobin before and after operation,and the hidden blood loss were recorded.Results The average body temperature of the heat preservation intervention group was higher than that of the routine treatment group,and the difference was statistically significant(P<0.05).The recessive blood loss was less than that of the routine treatment group,and the difference was statistically significant(P<0.05).The postoperative hemoglobin level of the compound heat preservation group was higher than that of the routine treatment group,and the difference was statistically significant(P<0.05).Conclusion The use of compound thermal insulation intervention in the treatment of senile intertrochanteric fracture with PFNA can effectively reduce the hidden blood loss of patients.