PFNA治疗老年股骨粗隆间骨折围手术期失血量的观察

目的观察股骨近端防旋髓内钉(PFNA) 治疗老年股骨粗隆间骨折患者的围手术期失血量。方法回顾性分析本院采取闭合PFNA内固定治疗的40例股骨粗隆间骨折患者的临床资料;将其不同时间段的隐性失血量及术中显性失血量进行比较。结果PFNA治疗股骨粗隆间骨折术后平均总隐性失血量是平均显性失血量的10倍以上。术后第4~5天与术后第1天、第2~3天比较差异均有显著性。结论PFNA治疗股骨粗隆间骨折围手术期隐性失血量远大于术中显性失血量。隐性失血主要发生在手术后的前3天，故术后前3天应密切监测患者的血红蛋白变化。

The Blood Loss in Perioperative Period of PFNA Treatment for Intertrochanteric Fractures

ObjectiveTo analyze the perioperative bloodloss ingeriatric intertrochanteric fractures treated with PFNA.MethodA retrospective analysis of clinical data in our hospital from 2011 January to 2012 June was conducted,including 40 cases of intertrochanteric fractures in patients who adopted the PFNA treatment;the hidden blood loss during different time periods was compared with the dominant blood loss.ResultsFor PFNA in treatment of femoral intertrochanteric fractures postoperative,the total hidden hemorrhage is more than 10 times that of the average dominant blood loss.For the first 4~5 days and the first day,the first 2~3 days after operation,there were significant differences.ConclusionPFNA in treatment of femoral intertrochanteric fracture during operation period,the hidden hemorrhage intraoperative blood loss is far greater than the dominant.Hidden blood loss occurred mainly in the first 3 days after the operation Frequent post-operative measurements of haemoglobin are necessary.