The analysis of perioperative blood loss during treatment of intertrochanter fracture with proximal femoral nail-antirotation in senile patients / 中国医师进修杂志

ABSTRACT

Objective To analyze the periopemtive blood loss of elderly patients with intertrochanter fracture that fixed with proximal femoral nail-antirotation (PFNA),and to explore the risk factor influencing the perioperative blood loss following PFNA fixation.Methods The clinical data of 62 elderly patients with intemochanter fracture treated with PFNA were analyzed retrospectively to determine the perioperative obvious blood loss and hidden blood loss.The impact of gender,age and fracture type on blood loss was also analyzed.Results The obvious blood loss of 62 patients was (120.6 ±42.0) ml,which accounted for 15.5％ in total blood loss [(775.8 ± 129.6) ml].The hidden blood loss was (655.2 ± 109.1) ml,which accounted for 84.5％ in total blood loss.The hidden blood loss was much more than obvious blood loss (P＜ 0.01).The total blood loss,obvious blood loss,hidden blood loss was (773.3 ± 131.5),(122.5 ± 44.1),(650.8± 114.2) mlinmahgroup (20cases),(777.0± 124.7),(119.7±40.2),(657.3 ± 107.7) ml in female group (42 cases),and there was no significant difference between two groups (P ＞ 0.05).The total blood loss,obvious blood loss was (813.1 ± 107.5),(117.7 ±49.7) ml in advanced age group (35 cases),(727.4 ± 114.3),(124.4 ± 36.6) ml in non-advanced age group (27 cases),and there was no significant difference between two groups (P ＞0.05).The hidden blood loss was (695.4 ±74.1) ml in advanced age group,(603.0 ± 65.3) ml in non-advanced age group,and there was significant difference between two groups (P＜0.05).The total blood loss,obvious blood loss,hidden blood loss was (578.1 ±82.3),(68.5 ±23.1),(509.6 ±63.1) ml in stable group (14 cases),(833.5 ±84.1),(135.8 ±35.0),(697.7 ±79.3) ml in unstable group (48 cases),and there was significant difference between two groups (P ＜ 0.05).Conclusions Hidden blood loss is the major part of perioperative blood loss of elderly patients with intertrochanter fractures that fixed with PFNA.Advanced age and unstable fracture type are risk factors of hidden blood loss.