目的 探讨PFNA治疗股骨粗隆间骨折隐性失血的特点及影响因素. 方法 回顾性研究2011年6月—2014年2月采用PFNA治疗的股骨粗隆间骨折的患者69例进行统计围手术期的隐性失血,对年龄、性别、肥胖及骨折类型进行分析,并分析隐性失血对术后康复的影响. 结果 男性组与女性组、肥胖组与非肥胖组间隐性失血均差异无统计学意义(P>0.05),高龄组的隐性失血量高于非高龄组(P<0.05). 在隐性失血量方面,不同骨折类型之间比较,差异均有统计学意义(P<0.05). 隐性失血量<650 mL与隐性失血量>650 mL组间术后弃拐时间差异有统计学意义(P<0.05);两组骨折愈合时间、患髋Harris评分均差异无统计学意义(P>0.05).结论 PFNA治疗股骨粗隆间骨折存在较多的隐性失血,性别、肥胖不是隐性失血的危险因素,高龄、骨折类型是隐性失血的危险因素,隐性失血对术后康复有重要影响.%Objective To explore the characteristics and influencing factors of the hidden blood loss during treatment of the in-tertrochanteric fracture with proximal femoral nail antirotation (PFNA). Methods A retrospectively analysis was performed on 69 patients with intertrochanteric fracture treated by PFNA from June 2011 to February 2014 for making clear the hidden blood loss in the perioperative period. The age, gender, obesity and type of fracture were analyzed. The impact of hidden blood loss on post-operative rehabilitation was also analyzed. Results There were no difference in hidden blood loss between male group and female group, obesity group and normal group(P>0.05). There were more hidden blood loss in advanced age group than non-advanced age group (P<0.05). There was significantly different difference in the hidden blood loss between different type of fracture group(P<0.05). There was significantly different difference in the discarding crutches time between the group whose hidden blood loss were less than 650mL and the group whose hidden blood loss were more than 650 mL (P<0.05), however, there was no significantly different difference in the fracture healing time and Harris score between the two groups (P>0.05).Conclusion There is much hidden blood loss during treatment of the intertrochanteric fracture with PFNA. Gender and obesity are not the risk factors of the hidden blood loss, but advanced age and fracture type are. The hidden blood loss has an important impact on the postoperative rehabilitation of the patients.
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