| ObjectiveTo improve the understanding towards hidden blood loss, through analyzing the blood loss during perioperative period of patients with treatment of intertrochanteric fractures in our hospital, from July 2015 to February 2016. This dissertation is aiming at, by observing the patients towards their HGB and HCT before and after operations and working out a statistical description of the results collected, giving theoretical support for the timing of blood transfusion during clinical perioperative period in the treatment of intertrochanteric fracture in the elder.MethodsThe clinical data of 50 patients with intertrochanteric fracture treated with PFNA between July 2015 to February 2016 were analyzed retrospectively. Patients included 18 males and 32 females, aged from 60 to 90, with an average age of 77.84. An analysis was done on blood routine of preoperative period and postoperative period by one hour, three hours and five hours respectively, and on intraoperative blood loss and postoperative suction drainage. The total perioperative blood loss and hidden blood loss were calculated by Gross formula. With the help of SPSS 23.0 and related literature, a statistical description was given.ResultsIn the study, the average age of 50 patients was (77.84±9.47) with 18 male and 32 female, aged between 60 and 90. The average height was (163.34 ±7.05)cm, from 155 to 175. The average BMI was (18.84±1.99)kg/m2 and the average duration of operation was (74.02±18.26) mins. Within the group with blood transfusion,8 were male and 19 were female, and there were 23 in the group without transfusion, with 10 male and 13 female. In the group with blood transfusion,the mean pre-operation HCT was(32.39±2.42)% and decreased to (26.86±2.25)% after operations, by 5.53%. The mean pre-operation HGB was 107.33g/L and declined to 88.78g/L, with a decrease of 18.15 g/L. Studies also found that the mean total blood loss was (1020.75±211.89)ml, with a mean hidden blood loss of (835.20±161.55)ml, accounting for 81.82%. In the other group without transfusion, the pre-operation HCT was (34.89±3.93)% and decreased to (28.74±3.56)%, by 6.15%. The mean pre-operation HGB was 117.96g/L, which deceased to 95.52g/L after operation, with a decrease of 22.44g/L. Without blood transfusion, the total blood loss was (650.35± 153.27)ml, with a mean hidden blood loss of (650.35±153.27)ml (87.93%). No statistical significance was found by comparing the hidden blood loss either between male and female or between the elder group and the control group, while there was considerable significance in comparing the statistics between groups with and without blood transfusion. There was no significant difference between the elderly group and non elderly group.ConclusionPFNA has more hidden blood loss during perioperative period, mainly happening three days after operations. There is no statistical significance comparing male and female.There was no significant difference between the elderly group and non elderly group while considerable significance was found by comparing the groups with and without transfusion. Much attention should be paid to patients after operations in terms of their hidden blood loss, in order to supplement the blood volume. There was no significant effect of operation time on the hidden blood loss. |
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