Analysis Of Blood Loss Of Femoral Intertrochanteric Fracture Treated With Intramedullary Fixation At Different Operation Time

Objective:To explore the difference of blood loss in different operation time of intramedullary fixation for intertrochanteric fracture of femur,so as to obtain data samples to guide clinical perioperative treatmentMethods:Retrospective analysis of patients with intertrochanteric fracture of femur who underwent surgical treatment in orthopaedics department of WeiFang Hospital of Traditional Chinese Medicine from January 2017 to August 2018.All patients were treated with proximal femoral anti-rotation intramedullary nails produced by Chuangsheng Company.All the patients were divided into group A,group B and group C according to different operation time,A group(within 48 hours),B group(more than 48 hours,less than or equal to 72 hours)and C group(more than 72 hours,less than or equal to 144 hours)Hemoglobin(Hb)and hematocrit(HCT)were measured before and after operation in each group.The sex,age,height,weight,routine time of blood test for the first time after injury,the time from trauma to operation and the operative time were recorded.The blood routine was checked one day before operation or the day before operation and the second,fifth and seventh days after operation.The patients whose hemoglobin value was less than 80g/L were given symptomatic transfusion treatment.The blood routine was taken as the final measurement of Hb and HCT on the second day after operation.Nadler’s equation was used to calculate the total blood volume,and Gross’s equation was used to calculate the total blood loss during perioperative period according to the difference of hematocritResults:1.In group A,PFNA was performed within 48 hours after injury.The total blood loss was(1200.66±356.98)ml and the latent blood loss was(1062.63±351.62)ml In group B,PFNA was performed within 48 to 72 hours after injury.The total blood loss was(836.42±318.53)ml and the latent blood loss was(697.86±329.42)ml.In group C,PFNA was performed within 72 to 144 hours after injury.The total blood loss was(856.43±345.96)ml and the latent blood loss was(719.25±330.96)ml.2.The total blood loss and recessive blood loss in group A were greater than those in group C,with statistical significance(P<0.05);the total blood loss and recessive blood loss in group A were greater than those in group B,with statistical significance(P<0.05);the total blood loss and recessive blood loss in group B and group C had no statistical significance(P>0.05)Conclusion:For patients with femoral intertrochanteric fracture treated with PFNA internal fixation,the total blood loss and latent blood loss of patients operated within 48 hours after injury were more than those of patients operated 48 hours after injury.Patients undergoing early post-traumatic surgery should closely observe the changes of blood volume after operation to correct anemia in time.