围手术期口服铁剂对老年股骨转子间骨折隐性失血的影响

目的探讨围手术期口服铁剂对老年股骨转子间骨折隐性失血量的影响,为临床治疗提供必要的参考依据。方法回顾性分析2010年3月至2014年10月本院采用股骨近端抗旋髓内钉(PFNA)内固定治疗的176例老年股骨转子间骨折患者临床资料,按围手术期是否规范口服琥珀酸亚铁治疗分为两组,对照组(90例)未使用铁剂,治疗组(86例)术后给予口服琥珀酸亚铁治疗12周。分别于术前、术后1d、14d、3个月行血常规检查,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。结果治疗组术后3月血红蛋白(Hb)平均为(118.6±6.7)g/L,对照组为(105.2±4.2)g/L,治疗组Hb明显高于对照组,差异有统计学意义(P0.05),治疗组患者平均隐性失血量为(515.6±25.6)mL,对照组患者平均隐性失血量为(505.4±15.8)mL,两组平均隐性失血量比较,差异无统计学意义(P0.05)。结论围手术期口服铁剂治疗并不能降低老年转子间骨折的隐性失血量,但可以明显改善贫血,是有效、经济、安全的治疗方法。

Effect of oral iron supplement during perioperative period on hidden blood loss in senile intertrochanteric fracture

Objective To investigate the effect of oral iron supplement during perioperative period on hidden blood loss in senile intertrochanteric fracture to provide the necessary reference for clinical treatment .Methods The clinical data in 176 cases of senile intertrochanteric fracture treated by proximal femoral nail anti‐rotary(PFNA) intr‐amedullary internal fixation in our hospital from March 2010 to October 2014 were retrospectively analyzed .The pa‐tients were divided into the two groups according to whether normatively taking ferrous succinate during the periop ‐erative period .The control group (90 cases) did not use the iron supplement and the treatment group (86 cases) was given oral ferrous succinate for 12 weeks after operation .The blood routine detection was performed before opera‐tion ,on postoperative1 ,14 d ,3 months .The preoperative and postoperative blood routine ,intraoperative and postop‐erative bleeding were analyzed in the two groups .The hidden blood loss during perioperative period in the two groups was evaluated .Results The average Hb level at postoperative 3 months in the treatment group was (118 .6 ± 6 .7) g/L ,and which in the control group was (105 .2 ± 4 .2)g/L ,the difference was statistically significant (P< 0 .05) ;the average hidden blood loss amounts in the treatment group was (515 .6 ± 25 .6)mL ,which in the control group was (505 .4 ± 15 .8)mL ,the difference between the two groups was not statistically significant (P> 0 .05) .Conclusion The oral iron supplement therapy does not reduce the hidden blood loss amount in senile intertrochanteric fracture , but can significantly improve anemia ,which is an effective ,economical and safe treatment method .