氨甲环酸对股骨转子间骨折术后隐性失血及下肢DVT的影响

发布时间：2018-10-18 11:04

【摘要】：目的：研究术后静脉予氨甲环酸对股骨转子间骨折PFNA内固定术后隐性失血的影响,并对术后深静脉血栓的风险进行评估。方法：选取2013年11月1日至2015年2月28日期间在广东省中医院骨二科行股骨近端防旋髓内钉(Proximal femoral nail antirotation, PFNA)内固定术的61例患者,并行随机分组。其中治疗组27例,对照组34例.年龄60-95岁,平均8100±7.43,手术时间59.43±21.33,住院天数12.61±5.22。两组患者性别、年龄、受伤致手术时间、左右侧、术前红细胞压积(Hematoric, Hct)、血红蛋白(Hemoglobin, Hb)等比较,均无统计学意义(P0.05)。术后比较两组患者术中出血量、隐性失血量、输血量、输血率,术后第7天复查D-Ⅱ聚体,结合Wells评分评估下肢深静脉血栓(Deep venous thrombosis, DVT)风险。结果数据应用统计软件SPSS 20.0进行统计分析。结果：治疗组和对照组的术中出血量分别为43.70±35.64ml和37.06±26.26ml,差异无统计学意义(P0.05)。两组术后隐性失血量分别为501.25±311.OOml和723.18±393.61ml,其中治疗组术后隐性失血量明显较对照组低,比较有统计学差异(P0.05)。两组术后隐性失血占术后总失血量的比率为85.74±19.01%、93.94±6.39%,比较无统计学差异(P0.05)。本研究所有病例术后7天D-Ⅱ聚体检验均阳性,术后治疗组、对照组Wells评分分别为1.70±1.203、1.38±0.604,比较无统计学差异(P0.05)。结论：术后6小时内静滴氨甲环酸氯化钠注射液能减少股骨转子间骨折闭合复位髓内钉内固定术隐性失血量,并无明显增加下肢DVT发生率的风险。
[Abstract]:Objective: to study the effect of intravenously transposinic acid on recessive blood loss after PFNA internal fixation for intertrochanteric fracture of femur, and to evaluate the risk of deep venous thrombosis after operation. Methods: from November 1, 2013 to February 28, 2015, 61 patients who were treated with (Proximal femoral nail antirotation, PFNA) internal fixation of the proximal femoral intramedullary nail in the second Department of Bone, Guangdong Provincial Hospital of traditional Chinese Medicine, were randomly divided into two groups. There were 27 cases in the treatment group and 34 cases in the control group. Age 60-95 years, mean 8100 卤7.43, operation time 59.43 卤21.33, hospitalization days 12.61 卤5.22. There was no significant difference in sex, age, operation time, left and right side, preoperative hematocrit (Hematoric, Hct), hemoglobin (Hemoglobin, Hb) between the two groups (P0.05). Postoperative blood loss, recessive blood loss and blood transfusion rate were compared between the two groups. D- 鈪，

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