背景:股骨颈囊外骨折(eFNF)是创伤学中第三常见的骨折类型。髓内钉(IMN)是eFNF最常用的正电子治疗方法之一。失血是这种治疗的主要并发症之一。这项研究旨在确定和评估导致IMN脆弱的eFNF患者输血的围手术期危险因素。
方法:从2020年7月至2020年12月,纳入170例接受IMN治疗的eFNF患者,并根据输血分为两组:NBT(71例不需要输血的患者),和BT(72名需要输血的患者)。性别,年龄,BMI,术前血红蛋白水平,国际标准化比率(INR)水平,输血的血液单位数,住院时间,手术持续时间,麻醉类型,术前ASA评分,Charlson合并症指数,和死亡率进行了评估。
结果:队列仅在术前Hb和手术时间方面存在差异(p<0.05)。
结论:术前Hb水平较低、手术时间较长的患者输血风险较高,围手术期应密切随访。
BACKGROUND: Extracapsular femoral neck fractures (eFNF) are the third most common type of fracture in traumatology. Intramedullary nailing (IMN) is one of the most frequently used ortho-pedic treatments for eFNF. Blood loss is one of the main complications of this treatment. This study aimed to identify and evaluate the perioperative risk factors that lead to blood transfusion in frail patients with eFNF who undergo IMN.
METHODS: From July 2020 to December 2020, 170 eFNF-affected patients who were treated with IMN were enrolled and divided into two groups according to blood transfusion: NBT (71 patients who did not need a blood transfusion), and BT (72 patients who needed blood transfusion). Gender, age, BMI, pre-operative hemoglobin levels, in-ternational normalized ratio (INR) level, number of blood units transfused, length of hospital stay, surgery duration, type of anesthesia, pre-operative ASA score, Charlson Comorbidity Index, and mortality rate were assessed.
RESULTS: Cohorts differed only for pre-operatively Hb and surgery time (p < 0.05).
CONCLUSIONS: Patients who have a lower preoperative Hb level and longer surgery time have a high blood-transfusion risk and should be closely followed peri-operatively.