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[股骨近端抗旋髓内钉治疗股骨粗隆间骨折围手术期输血危险因素分析]

[Analysis of risk factors of perioperative blood transfusion in the treatment of femoral intertrochanteric fracture with proximal femoral nail antirotation].

作者信息

Cheng Wen-Jing, Ding Guo-Zheng, Gong Yan-Hai

机构信息

Department of Traumatology and Orthopaedics, Yi jishan Hospital, Wannan Medical College, Wuhu 241000, Anhui, China.

出版信息

Zhongguo Gu Shang. 2021 Aug 25;34(8):755-8. doi: 10.12200/j.issn.1003-0034.2021.08.012.

Abstract

OBJECTIVE

To explore the influencing factors of perioperative blood transfusion in the treatment of elderly femoral intertrochanteric fractures with proximal femoral nail antirotation(PFNA).

METHODS

The clinical data of 109 elderly patients with intertrochanteric fractures who received PFNA treatment from July 2018 to January 2020 were retrospectively analyzed. Both pelvic hip X-rays and CT plain scans were performed before surgery. All patients were diagnosed by X-ray and CT plain scan of pelvis and hip before operation. Through the statistical analysis of the basic data of patients before and during operation, the risk factors of perioperative blood transfusion were explored.

RESULTS

Logistic regression analysis showed that age (=0.013), fracture type (<0.01), diabetes history (=0.031) and preoperative hemoglobin (<0.01) were independent risk factors for perioperative blood transfusion in the treatment of intertrochanteric fractures in elderly patients with 109 patients. Spearman correlation analysis showed that there was a positive correlation between blood transfusion and age of patients (= 0.017), fracture type (<0.01), diabetes history (=0.023), and negatively correlated with preoperative hemoglobin (<0.01). However, gender (=0.297), history of hypertension (=0.318) and operation time(=0.325) had no significant relationship with perioperative blood transfusion.

CONCLUSION

Age, fracture type, diabetes history, and preoperative hemoglobin are independent risk factors for perioperative blood transfusion in the treatment of elderly intertrochanteric fractures with PFNA. The older the patient, the history of diabetes, the more unstable the fracture, and the lower preoperative hemoglobin, the more likely it is to require a blood transfusion, which may provide a reference for clinical perioperative blood transfusion decisions.

摘要

目的

探讨采用股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折围手术期输血的影响因素。

方法

回顾性分析2018年7月至2020年1月期间接受PFNA治疗的109例老年转子间骨折患者的临床资料。术前均行骨盆髋部X线及CT平扫。所有患者术前均经骨盆及髋部X线及CT平扫确诊。通过对患者术前及术中基本资料的统计分析,探讨围手术期输血的危险因素。

结果

Logistic回归分析显示,年龄(=0.013)、骨折类型(<0.01)、糖尿病史(=0.031)及术前血红蛋白(<0.01)是109例老年患者转子间骨折治疗围手术期输血的独立危险因素。Spearman相关性分析显示,输血与患者年龄(=0.017)、骨折类型(<0.01)、糖尿病史(=0.023)呈正相关,与术前血红蛋白(<0.01)呈负相关。然而,性别(=0.297)、高血压病史(=0.318)及手术时间(=0.325)与围手术期输血无显著关系。

结论

年龄、骨折类型、糖尿病史及术前血红蛋白是采用PFNA治疗老年转子间骨折围手术期输血的独立危险因素。患者年龄越大、有糖尿病史、骨折越不稳定、术前血红蛋白越低,越有可能需要输血,可为临床围手术期输血决策提供参考。

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