Apelqvist Anna, Waldén Markus, Larsson Gert-Uno, Atroshi Isam
Department of Orthopedics, Hässleholm-Kristianstad, Hässleholm Hospital, Sweden.
Acta Orthop. 2009 Feb;80(1):26-31. doi: 10.1080/17453670902804893.
Patients with fracture of the proximal femur often undergo blood transfusion. A pneumatic compression bandage has been shown to reduce transfusion after primary hip arthroplasty for osteoarthritis. In this randomized trial, we evaluated the efficacy of this bandage following surgery for hip fracture.
288 patients, 50 years or older with 292 fractured hips treated with hemiarthroplasty or internal fixation (except pinning), were randomized to an experimental group with pneumatic wound compression applied after surgery (n = 138) and a control group with the same dressing but no compression (n = 154). Transfusion threshold was blood hemoglobin below 100 g/L. The primary outcome measures were the number of blood units and the proportion of patients transfused after surgery.
The primary outcome measures were similar in both groups. The mean number of postoperatively transfused blood units was 1.3 in the compression group and 1.1 in the non-compression group. Blood transfusion was given to 84 patients (62%) in the compression group and to 85 patients (55%) in the non-compression group.
Pneumatic wound compression does not reduce the need for transfusion after hip fracture surgery.
股骨近端骨折患者常需输血。已证实气动加压绷带可减少骨关节炎初次髋关节置换术后的输血量。在这项随机试验中，我们评估了该绷带在髋部骨折手术后的疗效。
288例50岁及以上患者，共292处髋部骨折，接受半髋关节置换术或内固定（不包括打钉）治疗，被随机分为术后应用气动伤口加压的试验组（n = 138）和使用相同敷料但不进行加压的对照组（n = 154）。输血阈值为血红蛋白低于100 g/L。主要结局指标为术后输血的单位数及输血患者的比例。
两组的主要结局指标相似。加压组术后平均输血量为1.3单位，非加压组为1单位。加压组84例患者（62%）接受了输血，非加压组85例患者（55%）接受了输血。
气动伤口加压并不能减少髋部骨折手术后的输血需求。
