[1]胡朝期,陈先进,张 军,等.氨基己酸在PFNA治疗老年性不稳定型股骨粗隆间骨折围手术期隐性失血量中的应用[J].医学信息,2021,34(05):120-123.[doi:10.3969/j.issn.1006-1959.2021.05.034]
　HU Zhao-qi,CHEN Xian-jin,ZHANG Jun,et al.Application of Aminocaproic Acid in PFNA Treatment of Perioperative Hidden Blood Loss in Senile Unstable Intertrochanteric Fractures[J].Medical Information,2021,34(05):120-123.[doi:10.3969/j.issn.1006-1959.2021.05.034]
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氨基己酸在PFNA治疗老年性不稳定型股骨粗隆间骨折围手术期隐性失血量中的应用()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年05期
页码:
120-123
栏目:
临床研究
出版日期:
2021-03-01

文章信息/Info

Title:
Application of Aminocaproic Acid in PFNA Treatment of Perioperative Hidden Blood Loss in Senile Unstable Intertrochanteric Fractures
文章编号:
1006-1959（2021）05-0120-04
作者:
胡朝期; 陈先进; 张 军; 等
（安徽中医药大学附属芜湖市中医医院骨科，安徽 芜湖 241000）
Author(s):
HU Zhao-qi; CHEN Xian-jin; ZHANG Jun; et al.
(Department of Orthopedics,Wuhu Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine, Wuhu 241000,Anhui,China)
关键词:
氨基己酸; 失血量; 股骨近端防旋髓内钉; 股骨粗隆间骨折; 股骨转子间骨折
Keywords:
Aminocaproic acid; Blood loss; Proximal femoral anti-rotation intramedullary nail;  Intertrochanteric fracture of the femur; Intertrochanteric fracture
分类号:
R683
DOI:
10.3969/j.issn.1006-1959.2021.05.034
文献标志码:
A
摘要:
目的 研究经静脉途径使用氨基己酸对减少PFNA手术治疗老年性不稳定型股骨粗隆间骨折患者围手术期隐性失血量的有效性及安全性。方法 选取2018年6月~2019年12月我院经PFNA内固定治疗的老年不稳定型股骨粗隆间骨折患者60例作为研究对象，采用随机对照原则分为治疗组和对照组，每组30例。两组患者均行PFNA手术治疗，治疗组在术前半小时及术后6 h分别将4 g氨基己酸配制于100 ml 0.9%生理盐水中静脉滴入，对照组则单纯使用等量生理盐水静脉输注，比较两组术前、术后第1天及第3天血红蛋白值（Hb）、红细胞比容（Hct）、术中显性出血量及围手术期总失血量、隐性失血量、输血率和术后并发症发生情况。结果 术后第1天、第3天治疗组Hb及Hct值均高于对照组，且围手术期总失血量、隐性失血量、输血率低于对照组，差异有统计学差异（P＜0.05）；两组切口愈合不良、下肢静脉血栓形成、脑梗塞并发症发生率比较，差异无统计学意义（P＞0.05）。结论 经静脉途径使用氨基己酸可有效减少经PFNA治疗的老年性不稳定型股骨粗隆间骨折患者围手术期失血量，同时可减少患者输血率，且不增加患者术后静脉血栓等并发症风险。
Abstract:
Objective To study the effectiveness and safety of intravenous administration of aminocaproic acid to reduce perioperative hidden blood loss in patients with PFNA surgery for unstable intertrochanteric fractures of the femur.Methods 60 elderly patients with unstable intertrochanteric fractures of the femur who were treated with PFNA internal fixation in our hospital from June 2018 to December 2019 were selected as the research objects.Using the principle of randomized control, they were divided into treatment group and control group, with 30 cases in each group.Both groups of patients underwent PFNA surgical treatment. In the treatment group, 4 g of aminocaproic acid was prepared by intravenous infusion in 100 ml of 0.9% normal saline half an hour before the operation and 6 h after the operation.In the control group, the same amount of normal saline was used for intravenous infusion, and the hemoglobin value (Hb), hematocrit (Hct), intraoperative significant bleeding, and perioperative comparison were compared between the two groups before operation and on the first and third days after operation. Period total blood loss, hidden blood loss, blood transfusion rate and postoperative complications.Results The Hb and Hct valuesof the treatment group were higher than those of the control group on the 1st and 3rd day after operation, and the total blood loss, hidden blood loss and blood transfusion rate during the perioperative period were lower than those of the control group,the difference was statistically significant (P<0.05);There was no significant difference in the incidence of poor incision healing, lower limb venous thrombosis, and cerebral infarction complications between the two groups (P>0.05).Conclusion The intravenous use of aminocaproic acid can effectively reduce the perioperative blood loss in patients with unstable intertrochanteric fractures of the elderly treated by PFNA, and at the same time can reduce the patient’s blood transfusion rate without increasing complications such as postoperative venous thrombosis risk.

参考文献/References:

[1]魏书一,李同相.股骨近端防旋锁定钉与锁定钢板内固定治疗老年股骨粗隆间骨折的疗效比较[J].实用临床医药杂志,2019,23(7):87-90. [2]徐驰,周勇,赵军,等.PFNA治疗老年股骨转子间骨折的隐性失血分析[J].中国矫形外科杂志,2018,26(6):510-515. [3]桂景雄,郭胜,许国泰,等.闭合复位PFNA治疗高龄老年股骨粗隆间骨折[J].创伤外科杂志,2018,20(3):218-220. [4]王军,高明,危杰,等.老年髋部骨折围手术期隐性失血量的相关影响因素分析[J].中华创伤骨科杂志,2015,17(2):143-146. [5]Bravo D,Josephson AM,Bradaschia-Correa V,et al.Temporary inhibition of the plasminogen activator inhibits periosteal chondrogenesis and promotes periosteal osteogenesis during appendicular bone fracture healing[J].Bone,2018(112):97-106. [6]Nadler SB,Hidalgo JH,Bloch T.Prediction of blood volume in normal human adults[J].Surgery,1962,51(2):224-232. [7]Gross JB.Estimating allowable blood loss: corrected for dilution[J].Anesthesiology,1983,58(3):277-280. [8]黄梓越,王磊,陈剑,等.PFNA与PFN治疗老年股骨粗隆间骨折的临床疗效[J].医学信息,2020,33(21):102-104. [9]李鹏飞,吕扬,周方.合并内侧壁骨折块的股骨粗隆间骨折的研究进展[J].中国微创外科杂志,2020,20(1):70-73. [10]Pattison E,Protheroe K,Pringle RM,et al.Reduction in haemoglobin after knee joint surgery[J].Ann Rheum Dis,1973,32(6):582-584. [11]王峰,李振武,尹锐锋,等.老年股骨转子间骨折围修复期隐性失血量与内固定植入物及性别的关系[J].中国组织工程研究,2016,20(4):544-548.

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更新日期/Last Update: 1900-01-01