| 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) |
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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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