The Multicenter And Retrospective Research Of The Relationship Between Monthly, Seasonal Variations And Post Hemorrhoids Operative Bleeding Rates

Objective:Our aim was to analysising the relativity between post hemorrhoids operative bleeding rates and monthly,seasonal variations,and hoping to help improving the safety of the surgical operation and preventing postoperative bleeding.Methods:A multicenter and retrospective reserch was undertaken to all the patients who had underwent hemorrhoids operation during 1st,Jan.2013 to 31th,Dec.2015 form Chengdu Special Hospital of Anus and Large Intestine,Affiliated Hospital of Chengdu University of traditional Chinese medicine, Chengdu first people's Hospital and Chengdu Third People's Hospital.We summarized the number of hemorrhoids patients,postoperative bleeding in monthly and quarterly, as well as the meteorological factors data during the same period.Statistical analysis was then finished by SPSS 17.0.Results:A total of 12650 patients were enrolled in this study,6379 patients were male,5911 female, and the ratio was 1.14:1. The age range from 18 to 83 [mean (47.33 ± 14.05)] years old.There were 190 cases of post operative bleeding, including 19 cases of primary hemorrhage,171 cases of secondary hemorrhage. The rate of hemorrhoids post operative bleeding from January to December was 1.29%,0.49%,1.56%,1.87%,1.62%,1.14%,0,99%,2.42%,1.72%,2.23%,1.61%, 1.02%, the difference was statistically significant (X2=21.51, P=0.028),the primary bleeding rate was 0.20%,0,0.07%,0.15%,0.18%,0.12%,0.22%,13%,0.09%,0.28%, 0.27% and 0.09%,the difference was not statistically significant (X2=5.37,P=0.91), the secondary bleeding rate was 1.10%,0.49%,1.49%,1.71%,1.45%,1.03%,0.77%, 2.30%,1.63%,1.96%,1.35% and 0.93%, the difference was statistically significant (X2=20.89,P=0.035).According to the Gregorian calendar,the rate of hemorrhoids post operative bleeding in spring, summer, autumn and winter was 1.71%,1.50%, 1.90%,0.94%, the difference was statistically significant (X2= 10.59, P= 0.014),the rate of the primary hemorrhage was 0.14%,0.16%,0.22% and 0.10%, the difference was not statistical significance (Xz=1.67, P= 0.643),the rate of secondary bleeding was 1.58%,1.34%,1.67%,0.84%, the difference was statistical significance (X2=9.52, P= 0.023). According to the lunar calendar, the rate of hemorrhoids post operative bleeding in spring, summer, autumn and winter was 1.42%,1.26%,2.19%and 1.14%, the difference was statistically significant (XM3.56, P= 0.004); the rate of primary hemorrhage was 0.05%,0.21%,0.3%,0.07%, the difference was statistically significant (X2= 878, P= 0.032),the rate of secondary bleeding was 1.42%,1.26%, 2.19%and 1.14%, the difference was statistical significance (X2= 10.26, P= 0.016).Spearman bivariate correlation analysis results showed that the association between the secondary hemorrhage rate and monthly average temperature (rho=0.273 P=0.391), average humidity (rho=0.134 P=0.678), average atmospheric pressure (rho=-0.175, P= 0.587),average wind speed (rho=0.129, P=0.690) was poor,the association between the secondary hemorrhage rate and seasonal average temperature (rho=0.2, P=0.8), average humidity (rho=0.4, P=0.6), average atmospheric pressure (rho=-0.4, P=0.6),average wind speed (rho=-0.2, P=0.8) was poor.Conclusion:(1)Operation time (monthly and seasonal variations)is one of the influence factors of post Hemorrhoid operation bleeding,especially the secondary bleeding.(2)There was a relativity between post hemorrhoids operative secondary bleeding rates and monthly variations,the highest rate in August, the lowest rate in February.(3)There was a relativity between post hemorrhoids operative secondary bleeding rates and seasonal variations,no matter based on the Gregorian calendar or lunar calendar. The rates from high to low were autumn, spring, summer and winter.(4)There was not an obvious correlation between post hemorrhoids operative secondary bleeding rates and meteorological factors,including average temperature, average humidity, average atmospheric pressure, average wind speed.(5)According to the idea of "zang-organs qi correspond to nature rhythms". the post hemorrhoids operative secondary bleeding rates in autumn and spring were higher than other seasons may related to the dysfunction of pulse and spleen qi.(6)To those hemorrhoids patients with many influence factors of post operative bleeding,selecting the operation time may reduce the risk of postoperative bleeding.