Hidden Blood Loss And Related Factors In Patients With Lumbar Disc Herniation Combined With Spondylolisthesis Undergoing PLIF

Objective To calculate the perioperative Hidden blood loss and analyze its related factors in patients with PLIF who suffering from lumbar disc herniation combined with spondylolisthesis.Therefore reducing Hidden blood loss and accelerating postoperative recovery.Methods A retrospective analysis was performed on the clinical data of 98 patients admitted to the orthopedics in the First Affiliated Hospital of Zhengzhou University from November 2017 to December 2019.They were diagnosed with lumbar disc herniation combined with spondylolisthesis and undergone operation named PLIF.Age,gender,Body mass index(BMI),surgical segment,surgical time,Hct before and 7 days after surgery,blood pressure,diabetes,hyperlipidemia,smoking and drinking history were included.After calculating and transforming the data,the Hidden blood loss and its related risk factors were analyzed by SPSS22.0 software.Results 57 male patients and 41 female patients of all 98 patients were counted in this survey.The average age was(52.3±8.6)years.The total blood loss during the perioperative period was(747.6±487.2)ml.The Hidden blood loss was(436.5±328.4)ml.There were 44 cases of positive Hidden blood loss,accounting for 44.90%;35cases underwent blood transfusion.By t-test,one-way analysis of variance,chi-square test,there were statistically significant differences in Hidden Blood Loss of patients aged>60 years,with hypertension,hyperlipidemia,and underwent blood transfusion was different from that of patients without comorbidities above(P<0.05).The difference in perioperative hidden blood loss between patients with single and three-segment surgery was different(P<0.05).The difference in perioperative hidden blood loss between patients with surgery duration?120min and?180min is statistically significant.There was no significant difference in perioperative hidden blood loss between patients with different genders,different body mass indexes(BMI),whether they had combined smoking or drinking history,and whether they had diabetes(P>0.05).There were no statistically significant differences in the hidden blood loss in patients with single-and double-segment surgery,double-segment surgery and triple-segment surgery(P>0.05).There was no statistically significant difference in hidden blood loss between the groups of patients?120min and 120-180min,120-180min,and?180min(P>0.05).Univariate and multivariate Logistic regression analysis found that advanced age,increased blood lipids,perioperative blood transfusion,and increased surgical segmentation were independent risk factors for perioperative hidden blood loss positive events.Conclusion Hidden blood loss in patients suffering from lumbar disc herniation combined with spondylolisthesis and having PLIF surgery accounts for a large proportion of total blood loss,which is generally consistent with previous studies.Advanced age,increased blood lipids,perioperative blood transfusion,and increased surgical segments are independent risk factors of positive Hidden blood loss in patients with lumbar disc herniation combined with spondylolisthesis underwent PLIF.