Effect Of Blood Pressure Level On Hidden Blood Loss After Intramedullary Nail Fixation Of Intertrochanteric Fracture In The Elderly

Objective: To investigate the correlation between blood pressure level and occult blood loss during perioperative period in elderly patients with intertrochanteric fracture treated with PFNA.Methods: the clinical data of 80 elderly patients with intertrochanteric fracture of femur treated by PFNA in the First Affiliated Hospital of Xinjiang Medical University from January 2018 to October 2019 were analyzed retrospectively.All the selected cases were the first time of illness.By observing the changes of HCT and Hb before and after operation,the hidden blood loss was calculated according to the relevant formula Then according to the blood pressure level of the patients,it was divided into three groups: normal blood pressure,high value blood pressure and hypertension.The relationship between the blood pressure level before and after operation and the recessive blood loss was analyzed.At the same time,the influence of hypertension history and anticoagulant on the recessive blood loss was analyzed.Results: the average recessive blood loss of all patients was(812.1±403.9)ml,the average dominant blood loss was(113.9±79.4)ml,the recessive blood loss was significantly greater than the dominant blood loss and the difference was statistically significant(P<0.05);the recessive blood loss of normal blood pressure group,high blood pressure group and hypertension group before operation was(561.9±452.3)ml,(848.3±393.6)ml,respectively,(952.1±304.7)ml;the percentage of recessive blood loss in total blood volume of three groups was(14.2±9.8)%,(21.2±10.5)%,(23.2±7.8)%,and the difference was statistically significant(P<0.05).There was no significant difference between the blood pressure level of three groups and recessive blood loss(P > 0.05).The occult blood loss was(915.5±440.1)ml,(708.8±338.8)ml,(P<0.05).The occult blood loss was(942.8±406.7)ml,(644.2±336.7)ml,(P<0.05).Conclusion: After PFNA minimally invasive surgery,the recessive blood loss is larger than the apparent blood loss.The higher the blood pressure level before surgery,the greater the recessive blood loss.Relevance should be paid attention to clinically,and actively seek relevant countermeasures to reduce the amount of hidden bleeding and reduce the risk of complications.