Bleeding Characteristic In Periods Of PVCR Intraoperative And A Comparison About Different Plasma Transfusion Scheme

ObjectiveDiscussing the characteristic intraoperative that posterior vertebral column resection(PVCR) for correction of severity spinal deformity and understanding whether fresh frozen plasma (FFP) can be stable blood coagulation function and decrease the hemorrhage, it is inputed in the front of starting vertebral resection.MethodsA retrospective analysis was performed concerning the clinical data of21patients with severity spinal deformity that were corrected by PVCR in the second affiliated hospital of kunming medical university orthopaedic from January2011to December2012. They were divided into two groups according to whether to start transfusing fresh frozen plasma in the front of starting vertebral resection. group A:to Start transfusing fresh frozen plasma in front of starting vertebral resection, a total of12cases, of which7cases male, female in5cases; group B:fresh frozen plasma began to be entered if I found blood clots to form the poor of the wound, Total9cases, of which the male in5cases, female4cases. The preoperative general information of two groups of patients were compared. And the whole operation procedure can be divided into three period.The first period:fixed segment are revealed and implanted with pedicle screws; The second period:resection of the vertebral body and correcting deformities; The third period:get bone, bone graft and suture of incision. the operation time and blood loss was collected of two groups of patients each period.the hemorrhage speed was calculated and compared each period. Indicators of function of blood coagulation at preoperative、finish nailing、orthopaedic complete、end of the surgery and indicators of postoperative recovery were compared. Measurement data was compared using t test and variance analysis, counting data was compared using X2test (exact probability method). ResultsTwo groups of patients with preoperative general data was no statistical difference (p>0.05);The hemorrhage speed of the second and the third phase of group A patients was slower than group B significantly (p<0.05);The index of blood coagulation function in patients of two groups finish nailing was no statistical difference (p>0.05). Comparison within the group:The clotting function index at orthopaedic complete of group A compared to finish nailing were no significant (p>0.05). PT and APTT at orthopaedic complete of group B compared to finish nailing were further extended (p<0.05); Comparison between groups:PT and INR of group B at orthopaedic complete compared to group A were longer (p<0.05), APTT, FIB, TT of two groups had no obvious statistical difference at orthopaedic complete (p>0.05). Index of two groups of blood coagulation function in patients were no significant statistical difference finishing operation (p>0.05). The total amount of blood loss and the quantity of all kinds of blood products that was transfused intraoperative in group A were less than group B (p<0.05).The fluid of drainage of group A after operation less than group B (p<0.05).A11patients had no venous thrombosis.other indicators had no significant difference (p>0.05).ConclusionStart transfusing fresh frozen plasma is the best time that improve blood coagulation function correcting severity spinal deformity by PVCR.1、Can slow down the bleeding speed of the second and the third phase effectively;2、The blood coagulation function can be maintained effectively in the middle and later periods of operation.3、Can decrease intraoperative blood loss and blood transfusion effectively.4、Help patients with postoperative recovery.