Effect Of Bushenhuoxue Fang Acid On The Hidden Blood Loss In The Perioperative Period Of The Elderly Femoral Intertrochanteric Fracture

Objective:Intertrochanteric fracture is a common form of senile fracture, and with the surgical treatment of mature, and more people realize that the conservative treatment of complications and case fatality rate is high, so the surgical treatment of intertrochanteric fracture has become a consensus. In the process of clinical treatment, we easily find intertrochanteric fracture patients perioperative often have larger hemoglobin (HB) and red blood cells deposited (HCT), and not in conformity with intraoperative bleeding, this phenomenon is called "hidden blood loss of hip fracture. Because of the bleeding overlooked, found that often appear different degree of anemia, severe anemia cause disease of heart head blood-vessel, even endanger the patient life, also increased the risk of perioperative complications occurred. Now the western medicine treatment to improve the recessive loss of blood, the effect is not very ideal, and repeated blood transfusion may cause infection and blood transfusion adverse reactions such as risk. This study aims to, through the method of treatment of traditional Chinese medicine, this paper discusses on the bushenhuoxue fang of intertrochanteric fractures of recessive hemorrhage and the effect of perioperative clinical surgical treatment for the disease to help.Methods:In February 2014 to February 2015, a total of 12 months, from the selection of orthopedics hospital affiliated to guangzhou university of Chinese medicine elderly orthopaedic into standard of 60 cases of patients with femoral intertrochanteric fracture. Will be included in the study of patients according to the envelope random grouping method is divided into two groups, treatment group and control group,30 cases each in the two groups are complete preoperative preparation and record the patient’s height, weight, preoperative HB and HCT. PFNA operation is the treatment group with kidney huoxue decoction, the control group only underwent surgical treatment, PFNA postoperative days 1,3,5 two groups all review routine blood, HB and HCT, and according to the Gross equation calculating the related data, compared the two groups before and after the treatment the clinical curative effect of the change and the curative effect of the differences between the two groups.Result:(1) Two groups of patients with postoperative days 1,2,3, reduce HCT than preoperative HCT, P<0.05, the difference is statistically significant, prove the existence of two groups before and after surgery in patients with loss of blood, and causes a decline in the red blood cells in the blood;Two groups of patients with postoperative day 2 HCT more postoperative 1 day,3 days after the second day after reduction, P<0.05, the difference is statistically significant, which indicates that two groups of 2,3 days postoperatively in patients with blood still exist;HCT 2 days,3 days postoperatively, the treatment group compared with control group, P<0.05, the difference is statistically significant, prove that the treatment group after 2 days,3 days HCT are higher than the control group, explain the less loss of red blood cells.(2) Is overt bleeding in both groups, P> 0.05, there was no statistically significant difference, that kidney invigorate the party does not effectively reduce apparent loss of blood. In the two groups after 2 days compared with preoperative and postoperative day 1 recessive bleeding, postoperative day 3 to day 2 recessive bleeding, postoperative using repetitive measure analysis of variance, P<0.05, the difference is statistically significant, prove the two groups of postoperative hidden blood loss gradually reduce. Two groups of preoperative and postoperative day 1 hidden blood loss, postoperative day 2 recessive bleeding, postoperative day 3 recessive bleeding, P< 0.05, the difference is statistically significant, indicating kidney invigorate the party can reduce the old age femoral intertrochanteric fracture of perioperative recessive loss of blood.(3) Postoperative day 1 HB, P> 0.05, there was no statistically significant difference, combined with the table 4, can infer is due to some patients in both groups allogeneic blood transfused.2 days after operation, postoperative day 3 HB, compared to the treatment group compared with control group, P< 0.05, differences has obvious statistical significance, shows that the treatment group 2 days after operation, postoperative day 3 HB are higher than the control group.Within the group two groups of patients with repeated measurement anova, P<0.05, the difference has obvious statistical significance, two groups of postoperative HB were gradually decrease over time, but the HB drop in treatment group was smaller than in the control group.Conclusion:(1) elderly femoral intertrochanteric fractures in perioperative far is dominant hidden blood loss of blood loss.(2) the bushenhuoxue fang can reduce the elderly femoral intertrochanteric fracture of the hidden bleeding.