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ID:15112540
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页数:12页
时间:2018-08-01
《pfna治疗老年股骨转子间骨折隐性出血分析》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、PFNA治疗老年股骨转子间骨折隐性出血分析【摘要】目的 分析股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的围手术期失血量,提高对老年股骨转子间骨折术后隐性失血的认识。方法 回顾性分析解放军309医院骨科在2008年6月—2010年12月,采取PFNA治疗的57例股骨转子间骨折患者,使用Gross方程,计算围手术期失血量。结果 57例患者中,男18例,女39例,平均年龄77.78岁。围手术期未输血的21例,其中男7例,女14例,平均年龄75岁;平均手术时间57.85min,术中显性失血共10
2、0.5ml。术前Hb平均123.1g/L,术后Hb96.9g/L,降低了26.5g/L;术前平均Hct0.3668,术后Hct0.2895,降低了0.0773。围手术期输血36例,男11例,女25例,平均年龄79.4岁,平均手术时间74.28min,术中显性失血197.1ml,平均输血量848.5ml,术前Hb平均108.5g/L,术后92.8g/L,降低了15.7g/L;术前Hct平均0.3197,术后0.2778,降低了0.0409。按Gross方程计算,两组围手术期平均理论失血量分别为825
3、ml和1127.5ml,其中隐性失血分别占86.448%和82.22%。结论 PFNA手术切口小,术中显性出血少,隐性失血量约是显性失血量的4倍以上,需引起临床上足够重视。【关键词】股骨转子间骨折;隐性失血;PFNA;围手术期;老年 [Abstract] Objective Toanalysethebloodlossinthe12perioperationfollowingPFNAforelderlypatientswithintertrochantericfracturesandtoincha
4、ncetheunderstandingonthehiddenbloodlossaftertheoperationofintertrochantericfracturesforelderlypatients.Methods Aretrospectivecaseseriesof57(male18,female39)patientswithanaverageof77.8year,operatedbetweenJune2008andDecember2010wasreviewed.Thebloodvolum
5、eanditsestimatedlosswerecalculatedbyGrossformula,onaccordingtothechangesofpre-andpost-operativehaemocrit(Hct).Results Therewere21casesinthenon-bloodtransfusiongroup(M=7,F=14)withaverageageof75years.ThemeanHaemoglobin(Hb)valuepre-opwas123.1g/Landpost-o
6、p96.9g/L(decrease26.5g/L),andthemeanHctvaluewas0.3668preopertivelyand0.2895postoperatively(decrease0.0773),respectively.Thecalculatedmeantotalbloodlosswas679ml,withobservedlossduringoperationanddrainage169ml.Therewere36patients(37.7%)inthebloodtransfu
7、siongroup(M=11,F=25)withmeanageof79.4years.Themeanbloodtransfusionvolumewas848.5ml.ThemeanHbvaluewas108.5g/Lpreoperativelyand92.8g/Lpostoperatively(decrease15.7g/L),themeanHctvaluewas0.3197and0.2778(decrease0.0409),respectively.Thecalculatedmeantotalb
8、loodlosswas1127.5ml.Thehiddenblood12lossoccupiedabout80%ofthetotalbloodlossvolume.Conclusion NailingofPFNA,althoughasmallincisionrapidprocedure,cancauseaconsiderablehiddenbloodloss,whichmayleadtoseverepostoperativeanemia. [Keywords] femoralin
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