本文選題：老年 + 股骨粗隆間骨折��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分析老年股骨粗隆間骨折閉合復(fù)位髓釘內(nèi)固定術(shù)后影響患者隱性失血的相關(guān)因素,于圍手術(shù)期評估相關(guān)因素以預(yù)防因隱性失血過多而導(dǎo)致貧血所引起的不良后果,從而保障臨床治療效果。方法:回顧性研究2014年9月至2016年3月接受閉合復(fù)位髓釘內(nèi)固定治療的86例老年股骨粗隆間骨折患者資料,根據(jù)Cross方程計算全部患者術(shù)后隱性失血量(postoperative hidden blood loss,PHBL)的絕對值及其所占總血容量(patient blood volume,PBV)的百分比(PHBL%),并分別以患者術(shù)后隱性失血量絕對值及其所占總血容量百分比為因變量,均以性別、身體質(zhì)量指數(shù)(body mass index,BMI)、術(shù)前是否抗凝、手術(shù)持續(xù)時間及術(shù)后是否輸血為自變量進行單因素分析及多元線性回歸分析。結(jié)果:1、術(shù)后隱性失血量絕對值組單因素分析顯示:患者術(shù)前是否抗凝及術(shù)后是否輸血的各組間隱性失血量絕對值的差異均有統(tǒng)計學(xué)意義(P0.05),多元線性回歸分析顯示:術(shù)前是否抗凝及術(shù)后是否輸血與術(shù)后隱性失血量絕對值呈線性回歸關(guān)系;2、術(shù)后隱性失血量占總血容量百分比(PHBL%)組單因素分析顯示:患者性別、BMI及術(shù)前是否抗凝的各組間的PHBL%差異均有統(tǒng)計學(xué)意義(P0.05),多元線性回歸分析顯示:性別、BMI及術(shù)前是否抗凝與術(shù)后的PHBL%呈線性回歸關(guān)系;3、男性組與女性組平均隱性失血量絕對值及PHBL%分別為(647.52±63.23)ml、(652.72±70.31)及14.2%±3.6%、18.6%±5.2%;(BMI≥24Kg/m2)組與(BMI24Kg/m2)組平均隱性失血量及PHBL%分別為(654.28±68.83)ml、(644.62±73.23)ml及13.1%±4.7%、17.8%±6.3%;術(shù)前抗凝組與未抗凝組平均隱性失血量及PHBL%分別為(682.83±66.23)ml、(639.56±72.52)ml及19.2%±3.3%、13.9%±4.1%;手術(shù)持續(xù)時間≥80min組與手術(shù)持續(xù)時間80min組平均隱性失血量及PHBL%分別為(655.37±66.87)ml、(648.58±78.36)及14.0%±4.3%、13.8%±7.1%;術(shù)后輸血組與未輸血組平均隱性失血量及其百分比分別為(627.76±53.64)ml、(660.62±70.16)ml及14.7%±6.0%、14.8%±3.6%。結(jié)論:隱性失血是導(dǎo)致老年股骨粗隆間骨折髓內(nèi)固定術(shù)后失血嚴(yán)重的主要原因,隱性失血量的絕對值與術(shù)前是否抗凝及術(shù)后是否輸血相關(guān),隱性失血量絕對值所占總血容量的百分比與性別、BMI及術(shù)前是否抗凝相關(guān)。
[Abstract]:Objective: to analyze the related factors influencing recessive blood loss after closed reduction and internal fixation of femoral intertrochanteric fracture in elderly patients, and to evaluate the related factors during perioperative period in order to prevent the adverse consequences of anemia caused by recessive hemorrhage.So as to ensure the clinical effect of treatment.Methods: the data of 86 elderly patients with intertrochanteric fracture of femur who were treated with closed reduction and intramedullary nail fixation from September 2014 to March 2016 were retrospectively studied.According to the Cross equation, the absolute value of postoperative hidden blood loss and the percentage of patient blood volume were calculated by Cross equation, and the absolute value of recessive blood loss and its percentage of total blood volume were taken as dependent variables, respectively.Sex, body mass index (BMI), body mass index (BMI), preoperative anticoagulation, duration of operation and blood transfusion were used as independent variables for univariate analysis and multivariate linear regression analysis.Results one factor analysis showed that there were significant differences in the absolute value of recessive blood loss between the two groups (P 0.05). The multiple linear regression analysis showed that there was no significant difference in the absolute value of recessive blood loss between the two groups before operation and whether blood transfusion was given after operation. Multivariate linear regression analysis showed that there were significant differences in the absolute value of recessive blood loss between the two groups.: there was a linear regression relationship between preoperative anticoagulant and postoperative blood transfusion and the absolute value of recessive blood loss after operation. The single factor analysis showed that the patient's gender BMI and preoperative anticoagulation were higher than that of PHBL group.Multivariate linear regression analysis showed that there was a linear regression relationship between PHBL% and sex BMI, and the mean recessive blood loss and PHBL% score in male and female groups were significantly higher than those in male and female groups.鍒負(fù)(647.52鹵63.23)ml,(652.72鹵70.31)鍙，

本文編號：1748698