本文選題：股骨粗隆間骨折 + 隱性失血��； 參考：《中國矯形外科雜志》2015年22期

【摘要】：[目的]探討老年股骨粗隆間骨折手術(shù)治療中影響隱性失血量的相關(guān)危險因素,提高對隱性失血的認(rèn)識,為臨床股骨粗隆間骨折圍手術(shù)期治療提供參考。[方法]回顧性分析本院2009年1月~2014年10月205例股骨粗隆間骨折患者臨床資料,其中符合納入標(biāo)準(zhǔn),并獲得完整病史資料有115例。隱性失血量通過手術(shù)前后紅細(xì)胞壓積變化,使用Gross方程,根據(jù)身高、體重和手術(shù)前后的紅細(xì)胞壓積(HCT)變化計算獲得,對患者性別、年齡、是否存在基礎(chǔ)疾病(高血壓、糖尿病)、骨折類型、內(nèi)固定方式、麻醉方式,受傷至手術(shù)時間,術(shù)前6個月內(nèi)是否服用抗血小板藥物,術(shù)后使用抗凝藥物進行統(tǒng)計分析,篩選出差異有統(tǒng)計學(xué)意義的因素,然后以隱性失血量為因變量,以各影響因素為自變量,進行多元線性回歸分析隱性失血的危險因素。[結(jié)果]患者術(shù)中顯性失血量為(210.12±171.34)ml,隱性失血量為(583.19±117.54)ml。單因素分析結(jié)果顯示,不同內(nèi)固定方式、骨折類型、麻醉方式、術(shù)前使用抗血小板或術(shù)后使用抗凝藥物隱性失血量差異顯著(P≤0.05),多重線性回歸分析結(jié)果顯示,對隱性失血量有顯著影響的因素有內(nèi)固定方式、骨折類型、麻醉方式、抗凝藥物應(yīng)用。[結(jié)論]隱性失血是老年股骨粗隆間骨折手術(shù)失血的主要原因,造成隱性失血的危險因素有內(nèi)固定方式、骨折類型、麻醉方式、抗凝藥物運用;臨床治療中,將顯性失血量作為補液、輸血的依據(jù)不可靠,要充分考慮隱性失血的存在,應(yīng)盡早干預(yù),預(yù)防并發(fā)癥發(fā)生。
[Abstract]:[objective] to explore the risk factors influencing the occult blood loss in the surgical treatment of intertrochanteric fracture of the femur, and to improve the understanding of the occult blood loss, and to provide a reference for the perioperative treatment of intertrochanteric fracture of the femur. [methods] the clinical data of 205 patients with intertrochanteric fracture of femur from January 2009 to October 2014 were retrospectively analyzed. Recessive blood loss was calculated by using Gross's equation, based on the changes of height, weight and HCT before and after surgery, to determine whether there were underlying diseases (hypertension) in patients' sex, age, and whether there were underlying diseases (hypertension). Diabetes mellitus, fracture type, internal fixation, anesthesia, time from injury to operation, whether or not to take antiplatelet drugs within 6 months before operation and anticoagulant drugs after operation were statistically analyzed. Then, the risk factors of recessive blood loss were analyzed by multivariate linear regression analysis, taking recessive blood loss as dependent variable and influencing factors as independent variables. [results] the apparent blood loss and recessive blood loss were 210.12 鹵171.34 ml and 583.19 鹵117.54 ml respectively. The results of univariate analysis showed that there were significant differences in internal fixation, fracture type, anesthesia, the amount of recessive blood loss before or after operation with antiplatelet or anticoagulant drugs (P 鈮，

本文編號：2049839