髓内钉固定术治疗股骨干骨折术后发生隐形失血的影响因素分析  

Analysis of influencing factors of invisible blood loss after intramedullary nail fixation for femoral shaft fracture

作　　者：张晓光[1] ZHANG Xiao-guang(Department of Emergency Surgery,the Second Affiliated Hospital of Luohe Medical College,Luohe,Henan 462300,China)

机构地区：[1]漯河医学高等专科学校第二附属医院急诊外科,河南漯河462300

出　　处：《医药论坛杂志》2024年第21期2270-2273,共4页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20221035)。

摘　　要：目的 探析髓内钉固定术治疗股骨干骨折术后发生率及隐形失血的影响因素。方法 择取2022年3月—2023年3月漯河医学高等专科学校第二附属医院行髓内钉固定术治疗的90例股骨干骨折患者,统计所有患者术后隐形失血发生情况,根据发生情况分为发生组和未发生组。以医院信息系统核查患者就诊记录和电子病例,获取患者相关临床信息,纳入具有统计学意义的变量构建logistic回归模型,分析髓内钉固定术治疗股骨干骨折术后发生隐形失血的影响因素。结果 研究共纳入90例股骨干骨折患者,其中高失血量组患者47例,占比52.22%,出血量范围500~730 mL,平均(650.54±50.67)mL;低失血量组患者43例,占比47.78%,出血量范围210~470 mL,平均(320.55±33.88)mL;经单因素分析结果显示,高失血量组合并症患者、年龄≥60岁、包扎方法局部包扎以及术前贫血占比高于低失血量组无合并症患者、年龄<60岁、包扎方法整体包扎以及术前无贫血占比(P<0.05);logistic回归显示,合并症、年龄、包扎方法以及术前贫血是髓内钉固定术治疗股骨干骨折术后发生隐形失血的影响因素(OR>1,P<0.05)。结论 髓内钉固定术治疗股骨干骨折术后隐形失血量较高,合并症、年龄、包扎方法以及术前贫血是髓内钉固定术治疗股骨干骨折术后发生隐形失血的影响因素。Objective To analyze the incidence rate and its influencing factors of invisible blood loss after intramedullary nail fixation for femoral shaft fracture.Methods From March 2022 to March 2023,90 patients with femoral shaft fracture treated by intramedullary nail fixation in our hospital were selected.The incidence of postoperative invisible blood loss in all patients was counted.According to the occurrence,they were divided into occurrence group and non-occurrence group.The hospital information system was used to verify the patient's medical records and electronic cases,and the patient's relevant clinical information was obtained.Results A total of 90 patients with femoral shaft fractures were included in the study,including 47 patients in the high blood loss group,accounting for 52.22%.The blood loss ranged from 500 to 730 mL,with an average of(650.54±50.67)mL;there were 43 patients in the low blood loss group,accounting for 47.78%.The amount of bleeding ranged from 210 mL to 470 mL,with an average of(320.55±33.88)mL;the results of univariate analysis showed that the proportion of patients with complications,age≥60 years old,local bandaging with bandaging method and preoperative anemia in the high blood loss group was higher than that in the low blood loss group without complications,age<60 years old,overall bandaging with bandaging method and preoperative anemia(P<0.05).Logistic regression showed that complications,age,bandaging method and preoperative anemia were the influencing factors of hidden blood loss after intramedullary nail fixation for femoral shaft fracture(OR>1,P <0. 05). Conclusion Age, bandaging method and preoperative anemia are the influencing factors of invisible bloodloss after intramedullary nail fixation for femoral shaft fracture.

关 键 词：髓内钉固定术 股骨干骨折 隐形失血 高血压 糖尿病 

分 类 号：R687.33[医药卫生—骨科学]