The Study Of The Effect Of Shen Mai Injection And Dan Shen Injection On The Perioperative Period Hidden Blood Loss Of The Femoral Intertrochanteric Fractures In Elderly Patients

ObjectiveAssessment of the effect of Shen Mai injection and Dan Shen injection on the perioperative period hidden blood loss of the femoral intertrochanteric fractures in elderly patients,give full play to their important role in reduce the risk factors of perioperative period of intertrochanteric fracture in the elderly patients.and provide clinical evidence for the prevention of hidden blood loss.Methods Elderly intertrochanteric fracture patients who were hospitalized from May.1st.2014 to Nov.28th.2015 and recived the PFNA operation in the second Department of orthopedics of Guangdong Province Troditional Chinese Medicine Hospital were chosen.Patients were divided randomly into three groups:experimental group(n=30),experimental control group(n=30)and blank control group(n=30).Experimental group:Shen Mai injection 40mL and Dan Shen injection 20mL intravenous drip,began from two days before operation to seven days after operation.Experimental control group:tranexamic acid injection 20mg/kg intravenous drip at the at beginning of operation,without using Shen Mai injection and Dan Shen injection.Blank control group:without using Shen Mai injection,Dan Shen injection and tranexamic acid injection.Record the hematocrit before operation and 1 day,3 days,7 days after operation.Calculate the hidden blood loss by Gross equation.Compare the visable and hidden blood loss,the volume of blood transfusion and blood transfusion rate,the hospitalization days and documented all complications.ResultsThe blank control group is consisted of 30 patients(6 males,24 females),with an average age of 82 and average weight of 51.35±7.48kg,20 left hips and 10 right hips,19 hypertensions,8 diabetes,6 cerebral infarctions,8 ischemic cardiomyopathys,5 arrhythmias,4 chronic obstructive pulmonary disease.The tranexamic acid group is consisted of 30 patients(11 males,19 females),with an average age of 81 and average weight of 55.58±10.5kg,19 left hips and 11 right hips,18 hypertensions,7 diabetes,9 cerebral infarctions,4 ischemic cardiomyopathys,2 arrhythmias,1 chronic obstructive pulmonary disease.The experimental group is consisted of 30 patients(7 males,23 females),with an average age of 84 and average weight of 51.75±8.12kg,15 left hips and 15 right hips,17 hypertensions,4 diabetes,8 cerebral infarctions,3 ischemic cardiomyopathys,3 arrhythmias,2 chronic obstructive pulmonary disease.The difference of sex,age,side,postoperational Hb and Hct,average operation time between the three groups had no statically significant(P>0.05).The perioperative total blood loss volume,perioperative total hidden blood loss volume and preoperative blood loss volume of experimental group were significantly lower than those of tranexamic acid group and blank control group(P<0.05).There were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between three groups(P>0.05).The Hb and Hct value in different time points had no statically significant differenc(P>0.05).Compare male patients only,there were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between three groups(P>0.05).Compare female patients only,there were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between three groups(P>0.05).Compare the patients with left hip fracture,there were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between three groups(P>0.05).Compare the patients with right hip fracture,there were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between the experimental group and the other two groups(P>0.05),But the postoperative visable blood loss of the tranexamic acid group is obviously lower than the blank group(P<0.05).Compare the patients whoes Hb?120g/L,there were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between three groups(P>0.05).Compare the patients whoes Hb<120g/L,there were no statistically significant difference of postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss between three groups(P>0.05).ConclusionFrom the results of this study we draw the conclusion that in the elderly patients of femoral intertrochanteric fracture who received PFNA operation.using the supplementing Qi and activating blood circulation method can reduce preoperative blood loss and thus reduce total blood loss and total hidden blood loss.but cannot reduce the postoperative total blood loss volume,postoperative total hidden blood loss volume and postoperative visable blood loss.No adverse reactions and complications were found during the study.