股骨粗隆间骨折患者局部骨密度对围手术期隐性失血的影响  

Effect of femoral trochanteric BMD on the perioperative hidden blood loss in patients with intertrochanteric fracture

作　　者：袁义[1] 张波[1] 罗浩[1] 杨超[1] 章海均[1] YUAN Yi;ZHANG Bo;LUO Hao;YANG Chao;ZHANG Haijun(Department of Joint,Center of Orthopedics,Ningbo No.2 Hospital,Ningbo 315010,China)

机构地区：[1]宁波市第二医院骨科中心关节外科,浙江宁波315010

出　　处：《全科医学临床与教育》2018年第2期153-155,167,共4页Clinical Education of General Practice

基　　金：宁波市科技惠民项目(2016C51003)

摘　　要：目的评估股骨粗隆骨密度对股骨粗隆间骨折患者围手术期隐性失血的影响。方法选取80例股骨粗隆间骨折患者,手术均由同一组医师采用股骨近端防旋髓内钉(PFN)内固定的方式完成,测量对侧股骨粗隆骨密度,根据骨密度分为骨密度正常组(20例)、骨密度减低组(26例)及骨质疏松组(34例),比较总失血量、显性失血量以及隐性失血量。结果术后共有7例患者接受了输血治疗,平均输血量为(358.46±125.22)ml。三组总显性失血量比较,差异无统计学意义(F=0.63,P>0.05),三组隐性失血量、总失血量比较,差异均有统计学意义(F分别=56.22、49.84,P均<0.05)。与骨质疏松组比较,骨密度正常组和骨密度减低组的隐性失血量、总失血量均明显减少,差异均有统计学意义(LSD-t分别=6.32、4.68、5.97、4.26,P均<0.05),骨密度正常组和骨密度减低组的隐性失血量、总失血量比较,差异均无统计学意义(LSD-t分别=1.02、0.84,P均>0.05)。结论股骨粗隆间骨折患者围手术期失血量主要以隐性失血为主,股骨粗隆骨密度是影响隐性失血的一个重要因素,应积极预防及治疗骨质疏松。Objective To evaluate the effect of different femoral trochanteric bone mineral density(BMD)on the perioperative hidden blood loss in patients with intertrochanteric fracture.Methods Totally 80 patients with femoral intertrochanteric fracture were treated with PFN and divided into the normal BMD group(20 cases),low BMD group(26 cases)and osteoporosis group(34 cases)according to the difference of the contralateral femoral trochanteric BMD.The total blood loss,hidden blood loss and dominant blood loss were evaluated.Results There are 7 patients received transfusion,the average volume was 358.46±125.22 ml.The difference in dominant blood loss among three groups was not statistically significant(F=0.63,P>0.05),while the differences in total blood loss and the hidden blood loss were statistically significant(F=56.22,49.84,P<0.05).The hidden blood loss in normal BMD group and low BMD group were significantly less than that in osteoporosis group as well as the total blood loss(LSD-t=6.32,4.68,5.97,4.26,P<0.05).The hidden blood loss and the total blood loss between the normal BMD group and low BMD group were not significantly different(LSD-t=1.02,0.84,P>0.05).Concusion Perioperative blood loss in intertrochanteric fractures mainly is hidden blood loss.Femoral trochanter bone mineral density is an important factor affecting hidden blood loss.We should actively prevent and treat osteoporosis.

关 键 词：骨密度 股骨粗隆间骨折 隐性失血 

分 类 号：R687.3[医药卫生—骨科学]