围术期输血治疗对老年股骨粗隆间骨折隐性失血的影响

目的探讨围术期输血治疗对老年股骨粗隆间骨折隐性失血量的影响,为临床治疗及输血指征的选择提供必要的参考依据。方法回顾性分析2010年3月至2011年10月采用股骨近端防旋髓内钉（PFNA）内固定治疗的176例老年股骨粗隆间骨折患者的临床资料,按围术期是否进行过输血治疗分为输血组（56例）及未输血组（120例）,对两组术前、术后血常规以及术中、术后出血等进行分析,对两组患者围术期的隐性出血量进行评估。结果输血组患者平均隐性失血量为353mL,占总失血量比例为83.1%,未输血组患者平均隐性失血量为427mL,占总失血量比例为84.6%。两组平均隐性失血量相比差异有统计学意义（P〈0.05）,平均隐性失血量占总失血量比例,两组比较无统计学意义（P〉0.05）。结论围术期输血治疗并不能降低老年粗隆间骨折的隐性失血量占总失血量的比例,术后应根据红细胞压积及血红蛋白量的变化,合理选择输血治疗,减少并发症的产生。

Effect of perioperative blood transfusion in treatment of hidden hemorrhage with intertrochanteric fracture

Objective To explore perioperative blood transfusion treatment for elderly intertrochanteric fracture hidden blood loss,providing the necessary reference for the clinical treatment and transfusion indications choice.Methods From march 2010 to October 2011,analysis 176 cases of elderly intertrochanteric fracture datas,who treatment by anti-rotation of the proximal femur intramedullary nail（PFNA）.According to the perioperative was a blood transfusion therapy forblood transfusion group（n=56） and without blood transfusion group（120 cases）,analysis of the preoperative and postoperative blood count,intraoperative and postoperative bleeding,to evaluate the hidden hemorrhage between two groups.Results Blood transfusion patients average hidden hemorrhage was 353 ml,the ratio was 83.1%.No blood transfusion patients average hidden hemorrhage was 427 mL,the ratio was 84.6%.Two groups of average hidden hemorrhage,there was statistically significant difference between two groups（P0.05）.the ratio between two groups was statistically significant difference（P0.05）.Conclusion Perioperative blood transfusion treatment couldn＇t reduce the hidden hemorrhage with elderly intertrochanteric fracture.Postoperative should be based on red blood cell press and the amount of hemoglobin,reasonable choice of blood transfusion treatment,reduce the complications of produce.