PFNA治疗粗隆间骨折隐性失血的危险因素研究  

Study on Risk Factors of Perioperative Hidden Blood Loss of PFNA Fixation for Femoral Intertrochanteric Fracture

作　　者：任磊[1] 孙永青[1] 崔准[1] 郝敬东[1] 蒋育欣 

机构地区：[1]首都医科大学电力教学医院,北京100073

出　　处：《实用骨科杂志》2015年第1期12-15,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨PFNA内固定治疗股骨粗隆间骨折围手术期隐性失血的危险因素及与髋关节功能的相关性。方法对82例接受PFNA治疗的股骨粗隆间骨折患者进行回顾性研究,根据Gross方程计算围手术期隐性失血量,以Pearson相关分析比较与术后6个月髋关节功能的相关性,对相关因素(性别、年龄、BMI、患侧、骨折分型、骨质疏松、高血压病、糖尿病、术前抗凝、伤后手术延迟时间、手术持续时间、术后输血)进行单因素分析及多元线性回归分析。结果围手术期隐性失血量为(645.38±84.98)m L,与髋关节功能呈负相关(r=-0.674,P<0.01);单因素及多元线性回归分析均显示,年龄、骨折分型、高血压病、糖尿病、术前抗凝、伤后手术延迟时间是影响PFNA内固定术后隐性失血量的危险因素(P<0.05)。结论隐性失血是影响股骨粗隆间骨折术后功能康复的重要因素之一,与年龄、骨折分型、内科合并症、伤后手术延迟时间、术前抗凝等因素密切相关。Objective To investigate risk factors of perioperative hidden blood loss of PFNA fixation for femoral intertrochanteric fracture, and relevance between hidden blood loss and hip function. Methods We retrospectively studied 82 cases of femoral intertrochanteric fractures treated with PFNA, perioperative hidden blood loss was calculated by Gross formula, and compared by Pearson analysis with hip function 6 months after operation. We also compated related factors （sex, age, BMI, ＇affected side ,fracture type, osteoporosis, hypertension, diabetes mellitus, preoperative anticoagulation, operation delay time after injury,operation duration,postoperative blood transfusion）by single factor analysis and multivariate linear regression analysis. Results Perioperative hidden blood loss was （645.38 ±84.98 ） mL, and it negatively correlated with the function of hip joint （r = -0. 674 ,P 〈 0.01 ） ;single factor analysis and multivariate linear regression analysis both show that the risk factors of pcrioperative hidden blood loss of PFNA fixation include age, fracture type, hypertension, diabetes mellitus, preoperative anticoagulation, operation delay time after injury（ P 〈 0.05 ）. Conclusion Hidden blood loss is one of key factors affecting hip function after PFNA fixation for femoral intertrochanteric fracture, and it closely associates with age ,fracture type, medical complication, preoperative anticoagulation and operation delay time after injury.

关 键 词：抗旋转股骨近端髓内钉 股骨粗隆间骨折 隐性失血 危险因素 

分 类 号：R683.42[医药卫生—骨科学]