股骨近端防旋髓内钉治疗老年股骨粗隆间骨折隐性失血的影响因素分析
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摘要
目的研究分析股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折(FIF)隐性失血的影响因素。方法回顾性分析2013年8月~2018年2月就诊于广东省深圳市龙岗区人民医院的80例老年FIF患者,所有患者均给予PFNA术式治疗,统计并记录患者的资料数据,随访6个月,分析患者的疗效情况,PFNA治疗FIF隐性失血的单因素及影响因素。结果 80例患者经过PFNA治疗后,总有效率为98.75%。年龄≥70岁、有基础疾病以及不稳定性骨折患者的隐性失血量均分别较年龄<70岁、无基础疾病及稳定性骨折者更高(P <0.05)。Logistic回归分析发现,PFNA治疗FIF隐性失血的影响因素包括年龄≥70岁、有基础疾病,以及不稳定性骨折(P <0.01)。结论应用PFNA治疗老年FIF患者的效果较好,导致其发生隐性失血的影响因素主要有年龄≥70岁、有基础疾病,以及不稳定性骨折,临床上可对上述因素采取干预措施以帮助患者获得更好的预后。
Objective To investigate and analyze the influencing factors of proximal femoral anti-rotation intramedullary nail(PFNA) in the treatment of senile intertrochanteric fracture(FIF). Methods Retrospective analysis was performed on 80 elderly FIF patients admitted to Shenzhen Longgang District People′ s Hospital from August 2013 to February2018, All patients were given PFNA operative treatment, and data of the patients were statistically recorded. The patients were followed up for 6 months to analyze the efficacy of the patients and the single and influential factors of PFNA in the treatment of FIF occult blood loss. Results After PFNA treatment, the total effective rate of 80 patients was98.75%. Recessive blood loss was higher in patients aged≥70 years, with basic diseases and unstable fractures than in patients aged <70 years, without basic diseases and stable fractures, respectively(P < 0.05). According to the Logistic regression analysis, the influencing factors of PFNA in the treatment of FIF occult blood loss include age ≥70 years old, basic diseases, and unstable fractures(P < 0.01). Conclusion The therapeutic effect of PFNA on the treatment of elderly FIF patients is relatively good, and the main influencing factors for the occurrence of recessive blood loss are age≥70 years old, underlying diseases, and unstable fractures. Clinically, intervention measures can be taken for the above factors to help patients obtain a better prognosis.
Objective To investigate and analyze the influencing factors of proximal femoral anti-rotation intramedullary nail(PFNA) in the treatment of senile intertrochanteric fracture(FIF). Methods Retrospective analysis was performed on 80 elderly FIF patients admitted to Shenzhen Longgang District People′ s Hospital from August 2013 to February2018, All patients were given PFNA operative treatment, and data of the patients were statistically recorded. The patients were followed up for 6 months to analyze the efficacy of the patients and the single and influential factors of PFNA in the treatment of FIF occult blood loss. Results After PFNA treatment, the total effective rate of 80 patients was98.75%. Recessive blood loss was higher in patients aged≥70 years, with basic diseases and unstable fractures than in patients aged <70 years, without basic diseases and stable fractures, respectively(P < 0.05). According to the Logistic regression analysis, the influencing factors of PFNA in the treatment of FIF occult blood loss include age ≥70 years old, basic diseases, and unstable fractures(P < 0.01). Conclusion The therapeutic effect of PFNA on the treatment of elderly FIF patients is relatively good, and the main influencing factors for the occurrence of recessive blood loss are age≥70 years old, underlying diseases, and unstable fractures. Clinically, intervention measures can be taken for the above factors to help patients obtain a better prognosis.
引文
[1]谢青,颜建华.当归补血汤治疗老年粗隆间骨折抗旋转股骨近端髓内钉术后隐性失血的临床效果[J].中国当代医药,2018,25(7):145-148.
[2]张海滨,刘先银,黎松波,等.探讨低分子肝素对股骨粗隆间骨折闭合复位髓内固定围手术期隐性失血的影响[J].中国实用医药,2018,13(17):106-108.
[3]王一新,吴相桥,杜辉君,等.两种手术方式治疗老年人不稳定型股骨粗隆间骨折失血量的比较[J].中华老年医学杂志,2018,37(1):71-73.
[4]陈伯亮,魏玉珊,赵轶男,等.InterTan髓内钉、PFNA内固定术治疗老年不稳定型股骨粗隆间骨折围手术期失血量对比观察[J].山东医药,2017,57(31):67-70.
[5]郭华洋,田聪,邵文慧,等.当归补血汤对老年股骨粗隆间骨折PFNA术后隐性失血及疗效影响的观察[J].广西中医药大学学报,2018,21(2):54-56.
[6]洪小丽,蔡义红.PFNA治疗老年股骨粗隆间骨折隐性失血的观察与护理[J].创伤外科杂志,2017,19(9):708-709.
[7]李锐军,林浙龙,周正茂,等.股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的隐性失血特点及影响因素[J].海南医学,2018,29(10):1366-1368.
[8] Yang X,Wu Q,Wang X,et al. Investigation of perioperative hidden blood loss of unstable intertrochanteric fracture in the elderly treated with different intramedullary fixations[J]. Injury,2017,48(8):1848-1852.
[9] Li B,Li J,Wang S,et al. Clinical analysis of peri-operative hidden blood loss of elderly patients with intertrochanteric fractures treated by unreamed proximal femoral nail antirotation[J]. Sci Rep,2018,8(1):3225-3226.
[10]徐光辉,张海参,杨晟兴,等.老年股骨粗隆间骨折PFNA治疗围手术期隐性失血分析[J].中国骨与关节损伤杂志,2016,31(4):403-404.
[11]侯子鑫,陈志伟,戴祝,等.PFNA治疗老年股骨粗隆间骨折围手术期失血量的观察[J].中南医学科学杂志,2013,41(2):177-180.
[12]侯磊.老年股骨粗隆间骨折PFNA治疗围手术期隐性失血分析[J].医学理论与实践,2017,30(24):3667-3668.
[13]李克鹏,郑义鹏,薛辉,等.股骨粗隆间骨折PFNA内同定围手术期患者的隐性失血量分析[J].实用妇科内分泌电子杂志,2017,4(32):46-49.
[14]秦永超,史立强,刘双会,等.PFNA治疗老年股骨粗隆间骨折隐性失血特点及影响因素分析[J].中医临床研究,2017,9(21):117-120.
[15]赵小林,梁智林,佟训哲,等.老年股骨粗隆间骨折患者围手术期失血分析及输血时机探讨[J].中华全科医学,2017,15(10):1649-1651.
[16]孙海波,彭阿钦,张万龙,等.PFNA治疗老年股骨粗隆间骨折隐性失血量相关性分析[J].实用骨科杂志,2014,20(7):600-603.
[17] Hao Z,Wang X,Zhang X,et al. Comparing surgical interventions for intertrochanteric hip fracture by blood loss and operation time:a network meta-analysis[J]. J Orthop Surg Res,2018,13(1):157-158.
[18]焦锋.四物汤对高龄粗隆间骨折PFNA术后隐性失血的影响[J].南京中医药大学学报,2017,33(5):501-503.
[19]徐龙,林清宇,王宝虎,等.股骨粗隆间骨折AO分型对围手术期隐性失血的影响[J].第二军医大学学报,2017,38(7):951-952.
[20]张桂林,孙勃.PFNA治疗股骨粗隆间骨折围手术期隐性失血的分析[J].临床医学研究与实践,2018,3(13):73-74.
[21] Xie H,Wang Z,Zhang J,et al. Clinical outcome of dynamic hip locking plates and proximal femoral nails anti-rotation-Asia for treating intertrochanteric femur fracture with lateral wall fractures in the elder patients[J].Oncotarget,2017,8(47):82700-82704.
[22]邓清民,黄兴桦.老年股骨粗隆间骨折患者围手术期失血分析及输血时机探讨[J].饮食保健,2018,5(9):116-117.
[23]方宜宥,周辉.十全大补汤治疗关节置换后隐性失血分析[J].中国现代医生,2018,56(11):137-140.
[24]李裕强,苏松森,黄建军,等.氨甲环酸治疗老年股骨转子间骨折PFNA术后隐性失血的疗效及安全性分析[J].中国医药科学,2017,7(11):29-31.
[25] Lei J,Zhang B,Cong Y,et al. Tranexamic acid reduces hidden blood loss in the treatment of intertrochanteric fractures with PFNA:a single-center randomized controlled trial[J]. J Orthop Surg Res,2017,12(1):124-125.
[26] Yu W,Zhang X,Wu R,et al. The visible and hidden blood loss of Asia proximal femoral nail anti-rotation and dynamic hip screw in the treatment of intertrochanteric fractures of elderly high-risk patients:a retrospective comparative study with a minimum 3 years of follow-up[J].BMC Musculoskelet Disord,2016,11(17):269-270.
[2]张海滨,刘先银,黎松波,等.探讨低分子肝素对股骨粗隆间骨折闭合复位髓内固定围手术期隐性失血的影响[J].中国实用医药,2018,13(17):106-108.
[3]王一新,吴相桥,杜辉君,等.两种手术方式治疗老年人不稳定型股骨粗隆间骨折失血量的比较[J].中华老年医学杂志,2018,37(1):71-73.
[4]陈伯亮,魏玉珊,赵轶男,等.InterTan髓内钉、PFNA内固定术治疗老年不稳定型股骨粗隆间骨折围手术期失血量对比观察[J].山东医药,2017,57(31):67-70.
[5]郭华洋,田聪,邵文慧,等.当归补血汤对老年股骨粗隆间骨折PFNA术后隐性失血及疗效影响的观察[J].广西中医药大学学报,2018,21(2):54-56.
[6]洪小丽,蔡义红.PFNA治疗老年股骨粗隆间骨折隐性失血的观察与护理[J].创伤外科杂志,2017,19(9):708-709.
[7]李锐军,林浙龙,周正茂,等.股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的隐性失血特点及影响因素[J].海南医学,2018,29(10):1366-1368.
[8] Yang X,Wu Q,Wang X,et al. Investigation of perioperative hidden blood loss of unstable intertrochanteric fracture in the elderly treated with different intramedullary fixations[J]. Injury,2017,48(8):1848-1852.
[9] Li B,Li J,Wang S,et al. Clinical analysis of peri-operative hidden blood loss of elderly patients with intertrochanteric fractures treated by unreamed proximal femoral nail antirotation[J]. Sci Rep,2018,8(1):3225-3226.
[10]徐光辉,张海参,杨晟兴,等.老年股骨粗隆间骨折PFNA治疗围手术期隐性失血分析[J].中国骨与关节损伤杂志,2016,31(4):403-404.
[11]侯子鑫,陈志伟,戴祝,等.PFNA治疗老年股骨粗隆间骨折围手术期失血量的观察[J].中南医学科学杂志,2013,41(2):177-180.
[12]侯磊.老年股骨粗隆间骨折PFNA治疗围手术期隐性失血分析[J].医学理论与实践,2017,30(24):3667-3668.
[13]李克鹏,郑义鹏,薛辉,等.股骨粗隆间骨折PFNA内同定围手术期患者的隐性失血量分析[J].实用妇科内分泌电子杂志,2017,4(32):46-49.
[14]秦永超,史立强,刘双会,等.PFNA治疗老年股骨粗隆间骨折隐性失血特点及影响因素分析[J].中医临床研究,2017,9(21):117-120.
[15]赵小林,梁智林,佟训哲,等.老年股骨粗隆间骨折患者围手术期失血分析及输血时机探讨[J].中华全科医学,2017,15(10):1649-1651.
[16]孙海波,彭阿钦,张万龙,等.PFNA治疗老年股骨粗隆间骨折隐性失血量相关性分析[J].实用骨科杂志,2014,20(7):600-603.
[17] Hao Z,Wang X,Zhang X,et al. Comparing surgical interventions for intertrochanteric hip fracture by blood loss and operation time:a network meta-analysis[J]. J Orthop Surg Res,2018,13(1):157-158.
[18]焦锋.四物汤对高龄粗隆间骨折PFNA术后隐性失血的影响[J].南京中医药大学学报,2017,33(5):501-503.
[19]徐龙,林清宇,王宝虎,等.股骨粗隆间骨折AO分型对围手术期隐性失血的影响[J].第二军医大学学报,2017,38(7):951-952.
[20]张桂林,孙勃.PFNA治疗股骨粗隆间骨折围手术期隐性失血的分析[J].临床医学研究与实践,2018,3(13):73-74.
[21] Xie H,Wang Z,Zhang J,et al. Clinical outcome of dynamic hip locking plates and proximal femoral nails anti-rotation-Asia for treating intertrochanteric femur fracture with lateral wall fractures in the elder patients[J].Oncotarget,2017,8(47):82700-82704.
[22]邓清民,黄兴桦.老年股骨粗隆间骨折患者围手术期失血分析及输血时机探讨[J].饮食保健,2018,5(9):116-117.
[23]方宜宥,周辉.十全大补汤治疗关节置换后隐性失血分析[J].中国现代医生,2018,56(11):137-140.
[24]李裕强,苏松森,黄建军,等.氨甲环酸治疗老年股骨转子间骨折PFNA术后隐性失血的疗效及安全性分析[J].中国医药科学,2017,7(11):29-31.
[25] Lei J,Zhang B,Cong Y,et al. Tranexamic acid reduces hidden blood loss in the treatment of intertrochanteric fractures with PFNA:a single-center randomized controlled trial[J]. J Orthop Surg Res,2017,12(1):124-125.
[26] Yu W,Zhang X,Wu R,et al. The visible and hidden blood loss of Asia proximal femoral nail anti-rotation and dynamic hip screw in the treatment of intertrochanteric fractures of elderly high-risk patients:a retrospective comparative study with a minimum 3 years of follow-up[J].BMC Musculoskelet Disord,2016,11(17):269-270.