文章摘要
石少辉,吴国平,李茂廷,等.扩髓对股骨转子间骨折患者Gamma-3内固定手术失血量的影响[J].安徽医药,2018,22(12):2362-2364.
扩髓对股骨转子间骨折患者Gamma-3内固定手术失血量的影响
Effect of reamed proximal femur on the blood loss of Gamma-3 internal fixation in patients with intertrochanteric fracture
投稿时间:2017-11-01  
DOI:
中文关键词: 股骨转子间骨折  Gamma-3  扩髓  失血量  隐性失血
英文关键词: Femoral intertrochanteric fracture  Gamma-3  Reaming  Blood loss
基金项目:航空总医院院内课题(YJYB201707)
作者单位E-mail
石少辉 航空总医院骨科,北京 100012  
吴国平 航空总医院骨科,北京 100012 drshishaohui@126.com 
李茂廷 航空总医院骨科,北京 100012  
李海啸 航空总医院骨科,北京 100012  
甄雨晴 航空总医院骨科,北京 100012  
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中文摘要:
      目的 观察股骨转子间骨折闭合复位Gamma-3内固定患者手术时股骨近端扩髓与否对失血量的影响。 方法 选取65岁以上股骨转子间骨折闭合复位Gamma-3内固定手术的135例患者为研究对象,所有患者分为三组。A组患者56例,插入髓内钉主钉前股骨髓腔不用扩髓器进行扩髓;B组患者18例,股骨髓腔周径窄,插入髓内钉主钉困难者需用扩髓器进行扩髓; C组患者61例,髓内钉主钉插入前主动用扩髓器进行扩髓。比较各组患者的总失血量、显性失血量、隐性失血量、手术时间等。 结果 A组患者术中显性失血量为(103±27) mL,B、C组患者术中失血量分别为(124±32) mL,(145±32) mL,三组比较差异无统计学意义(P>0.05)。A组患者隐性失血量为(440±26) mL;B、C组患者术中失血量分别为(634±32) mL,(701±32) mL,A组与B、C组相比差异有统计学意义(P<0.05)。A组患者总失血量为(543±32) mL;B、C组患者术中总失血量分别为(610±32) mL,(656±32) mL,A组与B、C组相比差异有统计学意义(P<0.05)。 结论 在老年股骨转子间骨折闭合复位Gamma-3内固定手术中,股骨近端扩髓增加隐性和总失血量;股骨近端扩髓是Gamma-3内固定手术失血的独立危险因素。
英文摘要:
      Objective To observe the effect of reamed proximal femur on blood loss in patients with femoral intertrochanteric fracture,when conducting close reduction and Gamma-3 internal fixation. Methods 135 patients aged over 65 with intertrochanteric fractures were enrolled in the study,who underwent close reduction and Gamma-3 internal fixation.All patients were divided into three groups.56 patients were picked out as group A,whose proximal femur were not reamed before inserting Gamma-3 intramedullary nail.18 patients were chosen as group B,whose proximal femur must be reamed with a reamer before inserting Gamma-3 intramedullary nail because of narrow cavity.61 patients were divided into group C,whose proximal femur were reamed with a reamer before inserting Gamma-3 intramedullary nail,according to the operation process routine. Results The blood loss was (103 ± 27) mL in group Aand (124 ± 32) mL and (145 ± 32) mL in group Band C,respectively (P>0.05).The hidden blood loss of group Awas (440 ±26) mL,and the blood loss in group Band group Cwas (634 ± 32) mL,(701 ± 32) mL (P<0.05).The total blood loss was (543 ± 32) mL in group Aand (610 ± 32) mL and (656 ± 32) mL in group Band C (P<0.05). Conclusion The proximal femoral reaming can increase the volume of total and hidden blood loss in old patients with intertrochanteric fracture,who are treated with close reduction and Gamma-3 internal fixation and proximal femoral reaming is an independent risk factor for blood lost.
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