摘要
目的分析InterTan治疗老年股骨粗隆间骨折的围手术期失血量,提高对其隐性失血的认识。方法回顾性分析本院在2010年12月～2013年5月,采取治疗的65例股骨粗隆间骨折患者手术前后的红细胞压积(Hct)变化,计算围手术期失血量。结果 65例患者中围手术期未输血的44例,男17例,女27例;平均年龄76.1岁,平均手术时间73.9min,术中显性失血及术后引流量共172.0mL,术前血红蛋白(Hb)平均118.6g/L,术后93.7g/L,降低了24.9g/L;术前Hct平均33.1,术后25.2,降低了7.9;采取输血支持的21例,男9例,女12例;平均年龄81.5岁,平均手术时间72.4min,术中显性失血及术后引流量共179.8mL,平均输血量624mL,术前Hb平均98.1g/L,术后94.5g/L,降低了3.5g/L;术前Hct平均30.1,术后28.1,降低了2.0。按方程计算,两组围手术期失血量分别为877mL和884mL,其中隐性失血分别占80.2%和81.2%。结论隐性失血的原因是多方面的,围手术期应特别注意补充血容量。对隐性失血的正确认识有助于提高围手术期安全性。
Objective To study the perioperative blood loss in geriatric intertrochanteric fractures treated with InterTan,and to enhance the clinical realization of hidden blood loss. Methods A retrospective case series of 65 （male 26,female 39） patients with an average of 77.3 year,operated between December 2010 and May 2013 was reviewed. The blood volume and its estimated loss were calculated on according to the changes of pre-and post- operative haemocrit （Het）. Results There were 44 cases in the non-blood transfusion group （M= 17, F= 27） with mean age of 76.1 years. The mean Haemoglobin （Hb） value pre-op was 118.6 g/L and post-op 93.7 g/L （decrease 24.9 g/L） ,and the mean Hct value was 33.1 preopertively and 25.2 postoperatively （decrease 7.94）, respectively. The calculated mean total blood loss was 877 mL,with observed loss during operation and drainage 172.0 mL. There are 21 patients in the blood transfusion group （M= 9 ,F= 12） with mean age o{ 81.5 years. The mean Hh value pre- op was 98.1 g/L and post-op 94.5 g/L （decrease 3.5 g/L） ,and the mean Hot value was 30.1 preopertively and 28. 1 postoperatively （decrease 2.0）,respectively. The calculated mean total blood loss was 884 mL, with observed loss during operation and drainage 179.8 mL. The hidden blood loss was occupied about 80% of the total blood loss volume. Conclusion There are more reasons of hidden hemorrhage. It＇s very important to supplement the blood volume during peroperative period. It may improve safety in perioperative period to estimate hidden blood loss.
出处
《成都医学院学报》
CAS
2013年第3期234-236,共3页
Journal of Chengdu Medical College
基金
全军十二五课题面上项目(NO:2011225007)
关键词
股骨粗隆间骨折
隐性失血
骨折内固定术
围手术期
Intertrochanterie fracture
Hidden blood loss
Fracture internal fixation
Perioperative period
