老年股骨粗隆间骨折围手术期静脉应用蔗糖铁的有效性及安全性

doi:10.6040/j.issn.1671-7554.0.2017.785

摘要/Abstract

摘要： 目的评估老年股骨粗隆间骨折围手术期静脉应用蔗糖铁的有效性与安全性。方法回顾性分析老年股骨粗隆间骨折采用股骨近端防旋髓内针(PFNA)内固定的手术患者81例(≥65岁)临床资料,根据入院后是否静脉应用蔗糖铁划分为治疗组(n=41例)和对照组(n=40例),治疗组为入院后静脉应用蔗糖铁,200 mg/次,连续3 d;对照组未应用蔗糖铁及其他铁剂。记录观察两组输血率、血红蛋白、血清铁蛋白、并发症发生情况及骨折愈合情况。结果治疗组输血率48.8%,对照组输血率52.5%,差异无统计学意义(P>0.05)。术后7、30、90 d血红蛋白含量:治疗组分别为(95.2±10.5)、(118.9±13.6)、(125.5±14.9)g/L;对照组分别为(90.1±12.1)、(109.8±12.8)、(118.6±12.3)g/L,两组差异有统计学意义(P<0.05)。两组血清铁蛋白术前均略高于正常值,术后明显升高,治疗组升高幅度大。两组并发症发生、骨折愈合情况差异无统计学意义(P>0.05)。结论围手术期静脉应用蔗糖铁能够提高老年股骨粗隆间骨折患者术后血红蛋白水平,改善贫血,但不能降低输血率。

关键词: 股骨粗隆间骨折, 内固定, 蔗糖铁, 输血

Abstract: Objective To evaluate the efficacy and safety of perioperative intravenous iron sucrose therapy in elderly patients with femoral intertrochanteric fracture. Methods A total of 81 patients with femoral intertrochanteric fracture(≥65 years)treated with proximal femoral nail anti-rotation(PFNA)were divided into two groups: treatment group(n=41), and control group(n=40). The treatment group received 200mg iron sucrose onceadayfor3 consecutive days after admission, while the control group did not receive any iron treatment. The blood transfusion rate, hemoglobin(HB),serum ferritin, complication rate and healing were compared between the two groups. Results The transfusion rate in the treatment group and control group was 48.8% vs 52.5%, with no significant difference between the two groups(P>0.05). The HB of 7, 30, 90 days postoperatively in the treatment group and control group were(95.2±10.5)vs(90.1±12.1),(118.9±13.6)vs(109.8±12.8), and(125.5±14.9)vs(118.6±12.3)g/L. There were significant differences between the two groups(P<0.05). The serum ferritin in both groups was higher than normal before surgery, and markedly increased after operation, especially in the treatment group. There were no significant differences in complication rate and fracture healing between the two groups(P>0.05). Conclusion Perioperative intravenous iron sucrose can increase HB and improve anemia in elderly patients with femoral intertrochanteric fracture, but it cannot reduce transfusion rate.

Key words: Femoral intertrochanteric fracture, Internal fixation, Iron sucrose, Transfusion

中图分类号:

R683.42

林锦秀,孙东升,郑潇,付开封,李晔,尹德超. 老年股骨粗隆间骨折围手术期静脉应用蔗糖铁的有效性及安全性[J]. 山东大学学报 (医学版), 2018, 56(1): 86-89.

LIN Jinxiu, SUN Dongsheng, ZHENG Xiao, FU Kaifeng, LI Ye, YIN Dechao. Efficacy and safety of perioperative intravenous iron sucrose therapy in elderly patients with femoral intertrochanteric fracture[J]. Journal of Shandong University (Health Sciences), 2018, 56(1): 86-89.

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