肥胖对股骨粗隆间骨折围手术期失血的影响  

Effects of Obesity to Perioperative Blood Loss Following Intertrochanteric Fracture Internal Fixation with PFNA

作　　者：潘铄[1] 冯涛[1] 刘晓辉[1] 田智广[1] 

机构地区：[1]石家庄市第一医院骨一科,石家庄050011

出　　处：《临床误诊误治》2016年第6期95-99,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省科技计划项目(132777256)

摘　　要：目的探讨肥胖对股骨粗隆间骨折围手术期失血的影响。方法选择2010年5月—2013年12月采用股骨近端抗旋髓内钉系统(PFNA)手术治疗的股骨粗隆间骨折134例,根据体重指数(BMI)分为肥胖组(BMI>30 kg/m2)41例和正常组(BMI≤30 kg/m2)93例。记录两组术前、术中、术后血常规,并计算围手术期不同时间点的失血量。结果两组均顺利完成手术,手术时间肥胖组、正常组分别为(52.9±14.1)min、(46.2±13.3)min,差异有统计学意义(P<0.05)。围手术期失血量分别为(879.3±63.8)ml、(785.9±45.2)ml,术前失血量分别为(281.2±26.3)ml、(264.1±15.9)ml,术后隐性失血量分别为(402.3±87.5)ml、(351.9±66.3)ml,差异均有统计学意义(P均<0.05);两组术中显性失血、隐性失血及术后显性失血量比较差异均无统计学意义(P>0.05)。结论股骨粗隆间骨折肥胖患者行PFNA时围手术期隐性失血量高于正常体重患者,临床医师应高度重视。Objective To investigate effects of perioperative blood loss for obese patients with intertrochanteric fracture treated with PFNA. Methods We retrospectively analyzed 134 cases undergoing PFNA for intertrochanteric fracture from May2010 to December 2013 in our hospital. The patients in the study were classified into obese group（ 41 patients） and normal group（ 93 patients） according to body mass index. The full blood count had been recorded before operation,during operation and after operation,and the calculation of perioperative blood loss during different operational periods had also been recorded.Results The duration of the operations was obviously different between the two groups,which were（ 52. 9 ± 14. 1） min in obese group and（ 46. 2 ± 13. 3） min in normal group. The mean blood loss was（ 879. 3 ± 63. 8） ml in obese group,and the mean blood loss in normal group was（ 785. 9 ± 45. 2） ml,the preoperative blood loss was（ 281. 2 ± 26. 3） ml,and（ 264. 1 ± 15. 9） ml separately,and the postoperative hidden blood loss was（ 402. 3 ± 87. 5） ml,（ 351. 9 ± 66. 3） ml separately,the differences were remarkable（ P〈0. 05）. There were no differences between the two groups in intraoperative visible blood loss,hidden blood loss and postoperative visible blood loss. Conclusion Clinical physicians should pay more attention to the obese patients,for they suffer larger number of hidden blood loss during different operational periods than the normal patients do.

关 键 词：股骨骨折 手术中并发症 出血 

分 类 号：R687.3[医药卫生—骨科学]