[1]蔡攀 陆燕 王秀会 付备刚△ 杨雷.老年股骨转子间骨折围手术期隐性失血与内固定 方式及骨折类型的相关性研究[J].中国中医骨伤科杂志,2015,23(11):28-31.
　CAI Pan LU Yan WANG Xiuhui FU Beigang YANG Lei.Correlation between Perioperative Hidden Blood Loss and Internal Fixation and Fracture Types in Senile Intertrochanteric Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2015,23(11):28-31.
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老年股骨转子间骨折围手术期隐性失血与内固定 方式及骨折类型的相关性研究
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第23卷
期数:
2015年11期
页码:
28-31
栏目:
临床研究
出版日期:
2015-11-15

文章信息/Info

Title:
Correlation between Perioperative Hidden Blood Loss and Internal Fixation and Fracture Types in Senile Intertrochanteric Fracture
文章编号:
1005-0205(2015)11-0028-04
作者:
蔡攀1 陆燕2 王秀会1 付备刚1△ 杨雷3
1.上海市浦东新区周浦医院骨科(上海,201318)
2.上海市浦东新区周浦医院检验科
3.温州医科大学附属第二医院骨科
△通信作者 E-mail:caipan19@163.com
Author(s):
CAI Pan1 LU Yan2 WANG Xiuhui1 FU Beigang1△ YANG Lei3
1.Department of Orthopedics, Zhoupu Hospital of Pudong New Area, Shanghai 201318,China;
2.Department of Clinical Laboratory, Zhoupu Hospital of Pudong New Area,Shanghai 201318,China;
3.Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang China.
关键词:
隐性失血;  老年人;  失血; 手术;  髋骨折
Keywords:
hidden blood loss;  the elderly;  blood loss;  surgery;  hip fracture
分类号:
R683.42
文献标志码:
A
摘要:
目的:探讨老年股骨转子间骨折围手术期隐性失血与两种不同内固定方式、骨折类型的相关性。方法:回顾性分析2008年3月-2013年10月232例分别应用动力髋螺钉(DHS)及股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折患者资料。DSH组91例:男40例,女51例; 平均年龄(76.6±6.5)岁。骨折按Evans-Jensen分型:其中Ⅰ型12例,Ⅱ型28例,Ⅲ型31例,Ⅳ型14例,Ⅴ型6例。PFNA组141例:男65例,女76例; 平均年龄(78.2±8.5)岁。骨折按Evans-Jensen分型:其中Ⅰ型6例,Ⅱ型34例,Ⅲ型49例,Ⅳ型33例,Ⅴ型19例。根据Gross方程计算隐性失血量,对隐性失血量与内固定方式、骨折类型进行相关分析。 结果:DSH组隐性失血量为(335.5±7.3)mL,PFNA组隐性失血量为(477.8±3.7)mL,稳定骨折组隐性失血量为(414.5±4.3)mL,不稳定骨折组隐性失血量为(467.5±5.9)mL.DSH组隐性失血量明显小于PFNA组,两组差异有统计学意义(P<0.05),骨折稳定组隐性失血量小于不稳定组,差异有统计学意义(P<0.05)。结论:老年股骨转子间骨折围手术期隐性失血与内固定方式、骨折类型密切相关,对于稳定的转子间骨折,使用DHS内固定,能明显减少隐性失血量。
Abstract:
Objective: To explore the correlation between perioperative hidden blood loss and two different kinds of internal fixation and fracture type in senile intertrochanteric fracture.Methods: 232 patients with senile intertrochanteric fracture treated with dynamic hip screw(DHS)and proximal femur nail antirotation(PFNA)were retrospectively analyzed from March 2008 to October 2013.DSH group of 91 cases, male 40 cases,female 51 cases, average(76.6 +6.5)years old.According to Evans-Jensen classification, 12 cases of type Ⅰ,typeⅡ28 cases, type Ⅲ 31 cases, type Ⅳ 14 cases and type Ⅴ6 cases.PFNA group of 141 cases, male 65 cases, female 76 cases, mean age(78.2±8.5)years, including 6 cases of type Ⅰ,type Ⅱ34 cases, type Ⅲ 49 cases, type Ⅳ 33 cases and type Ⅴ 19 cases.The correlation analysis was made between hidden blood loss, internal fixation and fracture type after the calculating of hidden blood loss based on Gross equations.Results: The hidden blood loss was(335.5±7.3)mL and(414.5±4.3)mL respectively for DHS group and PFNA group,and(414.5±4.3)mL and(467.5±5.9)mL respectively for stable fracture group and unstable fracture group.In the DHS group,the hidden blood loss was significantly less than in the PFNA group(P<0.05).And the hidden blood loss in the stable group was less than the unstable group,the difference was statistically significant(P<0.05).Conclusion: The perioperative hidden blood loss in senile intertrochanteric fracture is closely related to internal fixation and fracture types.For stable intertrochanteric fracture, DHS fixation can significantly reduce the hidden blood loss.

参考文献/References:

[1] 徐攀峰.股骨粗隆间骨折两种手术方案的比较[J].中国中医骨伤科杂志,2014,22(1):48-49.
[2] Davis FM,Woolner DF,Frampton C,et al.Prospective,multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly[J].Br J Anaesth,1987,59(9):1080-1088.
[3] 金宇恒,杨光,郝玉刚,等.LPFP及PFNAⅡ治疗老年股骨粗隆间粉碎骨折的比较[J].中国中医骨伤科杂志,2014,22(1): 54-55.
[4] Jensen JS,Michaelsen M Trochanteric femoral fracture treated with Mclaughlin osteosynthesis[J].Acta Orthop Scand,1975,46(5):795-803.
[5] 柳岩,牛杰,董智勇,等.闭合复位加股骨近端防旋髓内钉治疗老年股骨粗隆间骨折[J].中国中医骨伤科杂志,2014,22(8): 53-54.
[6] 王欣,金捷,时宏富,等.DHS和PFNA治疗老年股骨粗隆间骨折的效果比较分析[J].中国中医骨伤科杂志,2012,20(4): 32-34.
[7] Gross JB.Estimating allowable blood loss:corrected for dilution [J].Anesthesiology,1983,58(3):277-280.
[8] McManus KT,Velchik MG,Alavi A,et al.Non-invasive assessment of postoperative bleeding in TKA patients with Tc-99m RNCs[J].Nuclear Med,1987,28:565-567.
[9] 曾晶山,蔡贤华,李稳,等.老年股骨转子间骨折围手术期隐性失血量与性别、内固定方式相关性分析[J].中华创伤骨科杂志,2015,17(2): 134-137.
[10] 邓文广,许超,何滨,等.股骨粗隆间骨折Gamma3钉内固定的隐性失血分析[J].中国中医骨伤科杂志,2013,21(4): 12-14.
[11] Lawrence VA,Silverstein JH,Cornell JE,et al.Higher Hb level is associated with better early functional recovery after hip fracture repair[J].Transfusion,2003,43(12):1717-1722.
[12] 陆燕,蔡攀,汤明荣,等.围手术期输血治疗对老年股骨粗隆间骨折隐性失血的影响 [J].检验医学与临床,2013,10(16): 2086-2089.

备注/Memo

备注/Memo:
收稿日期:2015-05-08
基金项目:上海市医学重点专科基金资助项目(ZK2012B03)
上海市浦东新区卫生系统学科带头人培养计划(PW- Rd2012-12)
更新日期/Last Update: 2015-11-15