The Effect Of Hidden Blood Loss In The Elderly Patients Intertochanteric Fractures Between LMWHC And Rivaroxaban

Objective Objective to explore LMWHC and Rivaroxaban anticoagulate on the elderly patients with intertrochanteric fractures for the impact of hidden blood loss in perioperation.Methods Retrospective analysis of elderly patients with intertrochanteric fractures in our hospital from March 2009 to December 2014, a total of 112 cases were met with the inclusion and exclusion criteria.According to the different anticoagulate method,they were divided into three groups.38 cases in group of LMWHC (group A),42 cases in group of rivaroxaban(group B),32 cases in non-anticoagulation group(group C). The general clinical data of patients, intraoperative bleeding volume and postoperative drainage volume were recorded. Recorded the value of hematocrit (Hct) and hemoglobin (Hb) in preoperative and the first day,the third day and the seventh day of post-operative.Calculate the hidden blood loss by Cross and Nadler equation,and statistical analysis.Results The average hidden blood loss was (509.49±163.01)mL, accoun-ting for 65% of average total blood loss in 112 elderly patients with intertrochanteric fracture.The difference was not statistically significant among the comparison of the clinical data, the value of Hb and Hct at Preopera-tive,intraoperative bleeding volume and postoperative drainage volume in three groups(P> 0.05). Comparison of total hidden blood loss on the first day of postoperative among these three groups,the difference was not statistically> 0.05).But after 3th and 7th day at postoperative, the total hidden blood loss was (406.03±163.25) mL、(573.12±173.57) mL in the group of LMWHC, more than the group of rivaroxaban and group of non anticoagulation (P<0.05).Then, the total hidden blood loss and transfusion rate in the first three days were significantly higher than which of (4～7) days at postoperative in each group (P<0.01).Conclusion Compared with rivaroxaban,the amount of hidden blood loss was increase significantly in LMWHC anticoagulate for the elderly patients with intertrochanteric fractures.We should pay attention to monitoring the changes of Hb and Hct in the period of anticoagulation, especially in the first 3 days of the postoperative.