摘要
[目的]通过对股骨转子间骨折(intertrochanteric femoral fracture,IFF)病例施股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)微创术前后血容量(patients blood volume,PBV)变化的研究,分析原因、探讨防治措施。[方法]研究病例选自2009年6月至2012年4月间我院收治的IFF并实施PFNA术的285例患者的临床资料。骨折按AO分类,A1型28例,A2型142例,A3型115例,合并高血压101例,糖尿病72例,慢支85例。患者均在入院后行常规术前检查,入选病例要求无血液系统疾病,术前肝肾功能,凝血功能正常。所有患者均初行PFNA术,补液总量24h未过2000mL。本研究应用Gross方程,根据患者体重、身高及术前、术后红细胞比积(Hematocrit,Hct)计算所有患者的失血总量及显性失血量及隐性失血量,而后予该所得的临床资料以分析。[结果]患者实际总失血量平均(525±19.12)mL,术中出血(显性)平均(95±6.78)mL,隐性失血平均(430±12.10)mL,占总失血量81.90%。[结论]IFF围手术期失血应注意隐性失血量,在临床工作中应当注意复查血常规及给予相应治疗。
[Objective] To analyse and discuss the reason and preventive and treatment measures by administering proximal femoral nail anti-rotation（PFNA） to intertrochanteric femoral fracture（IFF） and observing the patients blood volume（PBV） changes.[Method] Choose the clinical data of 285 such cases,aged 55～84 and（69.37±7.16） years in average,classify them with AO,28 of A1 type,142 of A2,115 of A3,101 with hypertension,72 with diabetes and 85 with chronic bronchitis;all took PFNA operation,with fluid infusion less than 2000mL in 24h.The study used Gross equation;measure their blood-loss volume and dominant lost blood under the weight,height and Hct,i.e.total lost blood-dominant lost blood=recessive lost blood,then analyse all clinical data.[Result] The practical lost blood was（525±19.12）mL in average,the operational（dominant） lost blood（95±6.78）mL,recessive lost blood（430±12.10）mL,occupying 81.90% of total lost blood.[Conclusion] IFF perioperative period shall pay attention to recessive lost blood,blood routine examination and applying corresponding treatment in clinical work.
出处
《浙江中医药大学学报》
CAS
2012年第10期1099-1100,1116,共3页
Journal of Zhejiang Chinese Medical University
