目的 通过回顾性病例分析研究股骨粗隆间骨折围手术期隐性失血的影响因素,并探究需进行临床干预（院内输血）的危险因素。方法 回顾分析2020年1月—2022年12月入院的股骨粗隆间骨折患者病例资料,记录其性别、年龄、身高、体重、合并症、术前/术后血常规结果、术后并发症情况、手术方式、手术时间、术中失血量、输血情况等,并进行相应分组。使用t检验分析不同分组间失血量,使用二元logistic回归方法分析患者围手术期隐性失血而需院内输血的危险因素。结果 共回顾分析274例患者病例资料,其中男性125例,女性149例,左侧151例,右侧123例。患者均行手术治疗,无严重并发症,手术时间（65.16±23.61） min,总输血量（386±293） mL,总失血量（862±477） mL,其中隐性失血（753±444） mL,住院时间（12.77±4.69） d。不稳定骨折类型（Evans Ⅲ-Ⅳ型）是增加隐性失血的影响因素（P<0.05）。年龄、体重指数、合并症情况均对总失血量和隐性失血量无明显影响。手术时间长、术前血红蛋白含量低是围手术期隐性失血而需要输血的主要危险因素（P<0.05）。结论 不稳定的骨折类型是股骨粗隆间骨折围手术期隐性失血增加的影响因素,手术时间长、术前血红蛋白含量低是围手术期隐性失血而需住院期间输血的主要危险因素。
Objective To study the influencing factors of perioperative hidden blood loss of femoral intertrochanteric fractures and explore the risk factors for clinical intervention （in-hospital blood transfusion） using retrospective analysis. Methods Data of patients with intertrochanteric fracture admitted to our hospital from 2020 to 2022 were retrospectively analyzed. Their gender, age, height, weight, comorbidities, preoperative and postoperative blood routine test results, postoperative complications, surgical methods, operation time, intraoperative blood loss, and blood transfusion were retrieved, and grouped accordingly. A t-test was used to analyze the amount of blood loss between different groups, and a binary logistic regression was used to evaluate the risk factors for in-hospital blood transfusion secondary to perioperative hidden blood loss in patients. Results A total of 274 patients were retrospectively analyzed, including 125 males and 149 females, 151 cases with left fracture and 123 cases with right fractue. All of the patients were treated by surgery without serious complications. The average operation time was （65.16±23.61） min, the total blood transfusion volume was （386±293） mL, the total blood loss volume was （862±477） mL, of which the average hidden blood loss volume was （753±444） mL, and the average hospitalization was （12.77±4.69） d. Unstable fracture （Evans Ⅲ-Ⅳ） was an influencing factor for increased hidden blood loss （P<0.05）. Age, body mass index, and comorbidities had no significant effect on total blood loss or hidden blood loss volume. Long operative time and low preoperative hemoglobin level were main risk factors for blood transfusion secondary to perioperative hidden blood loss （P<0.05）. Conclusion Unstable fracture is an influencing factor for hidden blood loss during perioperative femoral intertrochanteric fractures, and long operation time and low preoperative hemoglobin level are risk factors for in-hospital blood transfusion secondary to perioperative hidden blood loss.
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