摘要
目的评估老年股骨转子间骨折患者内固定术后的营养状况,并分析其围术期隐性失血情况,为患者的临床诊疗提供指导。方法回顾性分析2017年9月至2018年7月间空军军医大学第二附属医院骨科收治的120例老年股骨转子间骨折患者内固定术后的诊疗状况。按不同的营养状态对患者进行分组,其中60例营养良好者为对照组,60例营养不良者为观察组。比较两组患者围手术期的隐性失血量、血红蛋白水平和红细胞比容(Hct)。结果观察组患者的入院即刻隐性失血量、术前隐性失血量及术后隐性失血量分别为(197.3±43.1)mL、(178.4±38.2)mL、(88.4±6.5)mL,明显大于对照组的(82.5±11.2)mL、(75.8±6.2)mL及(39.8±8.2)mL,差异均有统计学意义(P<0.05);观察组患者的入院即刻血红蛋白、术前血红蛋白及术后血红蛋白水平分别为(90.8±17.6)g/L、(84.6±14.3)g/L、(78.4±11.5)g/L,明显低于对照组的(118.5±11.5)g/L、(108.4±12.1)g/L、(93.2±8.2)g/L,差异均有统计学意义(P<0.05);观察组患者术后第一天、术后第二天及术后第三天的Hct分别为(28.32±2.2)%、(27.06±2.7)%、(27.61±2.6)%,明显低于对照组的(34.12±3.4)%、(32.24±2.8)%、(31.32±3.2)%,差异均有统计学意义(P<0.05)。结论老年患者股骨转子间骨折后随营养状况的恶劣隐性失血量逐渐增加,血清指标如总蛋白和白蛋白可用于评估老年人股骨转子间骨折内固定后的隐血失血。
Objective To evaluate the nutritional status of elderly patients with intertrochanteric fracture after internal fixation,and analyze the occult blood loss in perioperative period,so as to provide guidance for the clinical diagnosis and treatment of patients.Methods The diagnosis and treatment of 120 elderly patients with intertrochanteric fracture after internal fixation in Department of Orthopaedics,the Second Affiliated Hospital of Air Force Military Medical University from September 2017 to July 2018 were analyzed retrospectively.The patients were divided into two groups according to different nutritional status:60 in good nutrition status were in the control group and 60 in poor nutrition status were in the observation group.The occult blood loss,hemoglobin level and hematocrit were compared between the two groups.Results The occult blood loss on admission,before operation,after operation in the observation group were(197.3±43.1)mL,(178.4±38.2)mL,(88.4±6.5)mL,respectively,which were significantly higher than corresponding(82.5±11.2)mL,(75.8±6.2)mL,(39.8±8.2)mL in the control group(all P<0.05);the levels of hemoglobin on admission,before opearation,after operation in the observation group were(90.8±17.6)g/L,(84.6±14.3)g/L,(78.4±11.5)g/L,respectively,which were significantly lower than corresponding(118.5±11.5)g/L,(108.4±12.1)g/L,(93.2±8.2)g/L in the control group(all P<0.05);the hematocrit of the patients in the observation group on the first day,the second day and the third day were(28.32±2.2)%,(27.06±2.7)%,(27.61±2.6)%,which were significantly lower than corresponding(34.12±3.4)%,(32.24±2.8)%,(31.32±3.2)%in the control group(all P<0.05).Conclusion The amount of occult blood loss in elderly patients with intertrochanteric fracture increased gradually with poor nutritional status,the serum indexes such as total protein and albumin can be used to evaluate occult blood loss after internal fixation of femoral intertrochanteric fracture in the elderly.
作者
李亚利
桂萍
LI Ya-li;GUI Ping(Department of Orthopaedics,the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,Shaanxi,CHINA)
出处
《海南医学》
CAS
2019年第24期3194-3196,共3页
Hainan Medical Journal
关键词
股骨转子间骨折
内固定
围术期
隐性失血
营养状况
Intertrochanteric fracture
Internal fixation
Perioperative period
Occult blood loss
Nutritional status
