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随着老年患者股骨粗隆间骨折的逐渐增多,研究发现患者在手术后存在大量的隐性失血情况,影响患者术后康复,延迟功能锻炼并增加了术后并发症。目前临床研究表明,隐性失血的影响因素包括身高和体质量、性别、年龄、骨折类型、手术时机、手术方式等,隐性失血的治疗原则包括输血、应用铁剂和促红细胞生成素、应用氨甲环酸、合理使用抗凝药、应用传统中药等。
Abstract:With the gradual increase of femoral intertrochanteric fractures in elderly patients,the study found that there was a large amount of hidden blood loss after surgery,which affected patients' postoperative recovery,delayed functional exercise,and increased complications. In the continuous clinical exploration and research,the influencing factors of hidden blood loss include height and weight,gender,age,fracture type,surgical timing and method,et al. The treatment of hidden blood loss includes blood transfusion,application of iron,EPO,tranexamic acid,traditional Chinese medicine,and rational use of anticoagulants.
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基本信息:
中图分类号:R687.3
引用信息:
[1]代万武,黄祖权,郑杨越,等.老年股骨粗隆间骨折术后隐性失血的临床研究进展[J].老年医学研究,2020,1(02):61-64.
2020-12-25
2020-12-25