【摘要】：目的：研究術(shù)后靜脈予氨甲環(huán)酸對(duì)股骨轉(zhuǎn)子間骨折PFNA內(nèi)固定術(shù)后隱性失血的影響,并對(duì)術(shù)后深靜脈血栓的風(fēng)險(xiǎn)進(jìn)行評(píng)估。方法：選取2013年11月1日至2015年2月28日期間在廣東省中醫(yī)院骨二科行股骨近端防旋髓內(nèi)釘(Proximal femoral nail antirotation, PFNA)內(nèi)固定術(shù)的61例患者,并行隨機(jī)分組。其中治療組27例,對(duì)照組34例.年齡60-95歲,平均8100±7.43,手術(shù)時(shí)間59.43±21.33,住院天數(shù)12.61±5.22。兩組患者性別、年齡、受傷致手術(shù)時(shí)間、左右側(cè)、術(shù)前紅細(xì)胞壓積(Hematoric, Hct)、血紅蛋白(Hemoglobin, Hb)等比較,均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后比較兩組患者術(shù)中出血量、隱性失血量、輸血量、輸血率,術(shù)后第7天復(fù)查D-Ⅱ聚體,結(jié)合Wells評(píng)分評(píng)估下肢深靜脈血栓(Deep venous thrombosis, DVT)風(fēng)險(xiǎn)。結(jié)果數(shù)據(jù)應(yīng)用統(tǒng)計(jì)軟件SPSS 20.0進(jìn)行統(tǒng)計(jì)分析。結(jié)果：治療組和對(duì)照組的術(shù)中出血量分別為43.70±35.64ml和37.06±26.26ml,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組術(shù)后隱性失血量分別為501.25±311.OOml和723.18±393.61ml,其中治療組術(shù)后隱性失血量明顯較對(duì)照組低,比較有統(tǒng)計(jì)學(xué)差異(P0.05)。兩組術(shù)后隱性失血占術(shù)后總失血量的比率為85.74±19.01%、93.94±6.39%,比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。本研究所有病例術(shù)后7天D-Ⅱ聚體檢驗(yàn)均陽(yáng)性,術(shù)后治療組、對(duì)照組Wells評(píng)分分別為1.70±1.203、1.38±0.604,比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論：術(shù)后6小時(shí)內(nèi)靜滴氨甲環(huán)酸氯化鈉注射液能減少股骨轉(zhuǎn)子間骨折閉合復(fù)位髓內(nèi)釘內(nèi)固定術(shù)隱性失血量,并無(wú)明顯增加下肢DVT發(fā)生率的風(fēng)險(xiǎn)。
[Abstract]:Objective: to study the effect of intravenously transposinic acid on recessive blood loss after PFNA internal fixation for intertrochanteric fracture of femur, and to evaluate the risk of deep venous thrombosis after operation. Methods: from November 1, 2013 to February 28, 2015, 61 patients who were treated with (Proximal femoral nail antirotation, PFNA) internal fixation of the proximal femoral intramedullary nail in the second Department of Bone, Guangdong Provincial Hospital of traditional Chinese Medicine, were randomly divided into two groups. There were 27 cases in the treatment group and 34 cases in the control group. Age 60-95 years, mean 8100 鹵7.43, operation time 59.43 鹵21.33, hospitalization days 12.61 鹵5.22. There was no significant difference in sex, age, operation time, left and right side, preoperative hematocrit (Hematoric, Hct), hemoglobin (Hemoglobin, Hb) between the two groups (P0.05). Postoperative blood loss, recessive blood loss and blood transfusion rate were compared between the two groups. D- 鈪，

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