本文選題：髖骨折　切入點(diǎn)：氯吡格雷　出處：《第二軍醫(yī)大學(xué)學(xué)報(bào)》2017年04期 　論文類(lèi)型：期刊論文

【摘要】：目的探討圍手術(shù)期不停用抗血小板藥物早期微創(chuàng)手術(shù)治療老年髖部骨折的安全性。方法收集2012年1月至2013年12月采用股骨近端髓內(nèi)釘治療的老年股骨粗隆間骨折患者資料,其中32例因心腦血管疾患長(zhǎng)期口服抗血小板藥物而在不停用抗血小板藥物的情況下行早期閉合復(fù)位微創(chuàng)髓內(nèi)釘治療�；仡櫡治�32例患者的性別、年齡、美國(guó)麻醉醫(yī)師協(xié)會(huì)(ASA)分級(jí)、骨折AO分型、受傷到手術(shù)時(shí)間、術(shù)前和術(shù)后血紅蛋白、住院時(shí)間、ICU時(shí)間、出血量、術(shù)后輸血量、術(shù)后切口并發(fā)癥、全身并發(fā)癥以及1個(gè)月內(nèi)和1年內(nèi)死亡率等資料,評(píng)估不停用抗血小板藥物早期手術(shù)治療老年股骨粗隆間骨折患者的安全性。結(jié)果 32例患者中男性11例、女性21例,骨折時(shí)年齡65~81歲,單純使用氯吡格雷者25例、使用氯吡格雷聯(lián)合阿司匹林者7例,受傷到手術(shù)時(shí)間2~13(4.8±2.5)d,平均手術(shù)時(shí)間(89.0±33.2)min。術(shù)中出血量(242.9±83.7)mL,術(shù)后引流血量(259.8±94.9)mL,術(shù)后血紅蛋白(73±11)g/L,術(shù)后輸血量(390.2±103.1)mL。術(shù)后ICU停留時(shí)間為(1.7±0.9)d,住院時(shí)間為(12.5±2.5)d。發(fā)生術(shù)后切口并發(fā)癥3例(9.4%),其中2例切口愈合不良、1例切口周?chē)[。術(shù)后1個(gè)月內(nèi)并發(fā)急性心血管事件3例(9.4%),急性腦卒中2例(6.2%),肺炎2例(6.2%),壓瘡1例(3.1%)。術(shù)后1個(gè)月內(nèi)死亡3例(9.4%),術(shù)后1年內(nèi)死亡12例(37.5%)。結(jié)論不停用抗血小板藥物早期微創(chuàng)手術(shù)治療長(zhǎng)期服用抗血小板藥物合并股骨粗隆間骨折的老年患者,不會(huì)增加1年內(nèi)患者的局部和全身并發(fā)癥發(fā)生率。
[Abstract]:Objective to investigate the perioperative discontinuation of antiplatelet drugs in early minimally invasive surgery in the treatment of the safety of the elderly hip fracture. Methods from January 2012 to December 2013 using the proximal femoral nail in treatment of intertrochanteric fractures of elderly patients, including 32 cases of cardiovascular disease because of long-term oral antiplatelet drugs without discontinuation of antiplatelet drugs in the downlink of early minimally invasive intramedullary nail in the treatment of 32 cases were retrospectively analyzed. The gender, age, American Society of anesthesiologists (ASA) classification, AO classification, injury to the operation time, preoperative and postoperative hemoglobin, hospitalization time, ICU time, bleeding volume, postoperative blood transfusion, incision complications, systemic data and the complications within 1 months and 1 year mortality, evaluation of discontinuation of antiplatelet drugs in early surgical treatment of femoral intertrochanteric fractures in the elderly patients with safety. Results 32 渚嬫?zhèn)ｈ�呬腑鐢鋒，

本文編號(hào)：1615300