【摘要】：目的：研究術后靜脈予氨甲環(huán)酸對股骨轉子間骨折PFNA內固定術后隱性失血的影響,并對術后深靜脈血栓的風險進行評估。方法：選取2013年11月1日至2015年2月28日期間在廣東省中醫(yī)院骨二科行股骨近端防旋髓內釘(Proximal femoral nail antirotation, PFNA)內固定術的61例患者,并行隨機分組。其中治療組27例,對照組34例.年齡60-95歲,平均8100±7.43,手術時間59.43±21.33,住院天數(shù)12.61±5.22。兩組患者性別、年齡、受傷致手術時間、左右側、術前紅細胞壓積(Hematoric, Hct)、血紅蛋白(Hemoglobin, Hb)等比較,均無統(tǒng)計學意義(P0.05)。術后比較兩組患者術中出血量、隱性失血量、輸血量、輸血率,術后第7天復查D-Ⅱ聚體,結合Wells評分評估下肢深靜脈血栓(Deep venous thrombosis, DVT)風險。結果數(shù)據(jù)應用統(tǒng)計軟件SPSS 20.0進行統(tǒng)計分析。結果：治療組和對照組的術中出血量分別為43.70±35.64ml和37.06±26.26ml,差異無統(tǒng)計學意義(P0.05)。兩組術后隱性失血量分別為501.25±311.OOml和723.18±393.61ml,其中治療組術后隱性失血量明顯較對照組低,比較有統(tǒng)計學差異(P0.05)。兩組術后隱性失血占術后總失血量的比率為85.74±19.01%、93.94±6.39%,比較無統(tǒng)計學差異(P0.05)。本研究所有病例術后7天D-Ⅱ聚體檢驗均陽性,術后治療組、對照組Wells評分分別為1.70±1.203、1.38±0.604,比較無統(tǒng)計學差異(P0.05)。結論：術后6小時內靜滴氨甲環(huán)酸氯化鈉注射液能減少股骨轉子間骨折閉合復位髓內釘內固定術隱性失血量,并無明顯增加下肢DVT發(fā)生率的風險。
[Abstract]:Objective: to study the effect of intravenously transposinic acid on recessive blood loss after PFNA internal fixation for intertrochanteric fracture of femur, and to evaluate the risk of deep venous thrombosis after operation. Methods: from November 1, 2013 to February 28, 2015, 61 patients who were treated with (Proximal femoral nail antirotation, PFNA) internal fixation of the proximal femoral intramedullary nail in the second Department of Bone, Guangdong Provincial Hospital of traditional Chinese Medicine, were randomly divided into two groups. There were 27 cases in the treatment group and 34 cases in the control group. Age 60-95 years, mean 8100 鹵7.43, operation time 59.43 鹵21.33, hospitalization days 12.61 鹵5.22. There was no significant difference in sex, age, operation time, left and right side, preoperative hematocrit (Hematoric, Hct), hemoglobin (Hemoglobin, Hb) between the two groups (P0.05). Postoperative blood loss, recessive blood loss and blood transfusion rate were compared between the two groups. D- 鈪，

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