Analysis Of Factors Related To Hidden Blood Loss In Perioperative Period Of Senile Hip Fractures And Prevention By Traditional Chinese Medicine

Objective:Based on 144 cases of elderly hip fracture patients with clinical data collection,the relative factors of the perioperative hidden blood loss are retrospectively analyzed,and to assess Jiawei Taohong Siwu Tang of Chinese medicine on patients with this class,to provide reference for clinical.methods:Retrospective analysis is performed on senile patients with hip fractures admitted to the inpatient department of orthopedics in the Hubei Provincial Traditional Chinese Medical Hospital from January 2017 to October 2019,recording the patients’basic information,basic diseases,fracture type,operation,preoperative time,operation time,Length of stay,perioperative hospital admission(1D,preoperative and postoperative 1,3,7D)routine blood,preoperative albumin and preoperative D-dimer,color doppler ultrasound of arteriovenous of lower limbs,blood transfusion volume,whether taking traditional Chinese medicine.According to inclusion and exclusion standards,a total of 144 cases of patients with hip fracture are incorporated into the research,and the potential risk factors are screened by Bivariate Correlation test and Independent Sample t test for perioperative hidden blood loss.In addition,Multiple Linear Regression Analysis is applied to study the related influencing factors and to assess Jiawei Taohong Siwu Tang of Chinese medicine on patients with this class.Results:Among the 144 senile patients with hip fracture,66 are males and 78 are females,aged 60-96 years with an average age of78.8 years.BMI ranges from 18.73 to 26.91 kg/m~2,with an average of(21.92±1.43)kg/m~2.There are 77 patients with right hip fracture and 67 patients with left hip fracture.There are 86 patients with hypertension and 33 patients with diabetes.Color doppler ultrasound showed 6 cases of vascular sclerosis with thrombosis and79 cases of vascular sclerosis with plaque.71 patients underwent hemi or total hip arthroplasty,and 73 patients underwent PFNA.The mean preoperative time is(7.72±4.14)d,and the mean surgical duration is(2.26±1.09)h,and the mean length of stay is(21.67±7.49)d,and the average preoperative albumin is 35.12g/L,and the median preoperative d-dimer is 3.95mg/L.The average total blood loss is(879.50±585.54)mL,and the average visual blood loss is(188.96±151.67)mL,and the average hidden blood loss is(690.54±508.53)mL,accounting for 78.52%of the total blood loss.A total of 80 patients received blood transfusion with an average volume of(656.88±429.07)mL.During the perioperative period,a total of 71 patients were treated with Jiawei Taohong Siwu Tang of Chinese medicine and 73 patients were not treated with Jiawei Taohong Siwu Tang of Chinese medicine.Including age,BMI,side,high blood pressure,diabetes,preoperative time,preoperative albumin,preoperative D-dimer,double vascular condition of lower limbs,operation method for the influence of the hidden blood loss are no statistical significance(p>0.05),and the operation time(t=3.581,p<0.001),gender(t=4.043,p<0.001),fracture type(t=2.175,p<0.05),Chinese medicine intervention group(t=3.933,p<0.001)are the relevant factors affecting the hidden blood loss,goodness-of-fit test determination coefficient R~2=0.344,adjusted R~2=0.308.The significance test of regression equation F=9.649,p<0.001,is statistically significant,and the linear relationship of regression equation is significant too.According to the standardized coefficient Beta value,the influencing factors from large to small are fracture type(Beta=0.391),Chinese medicine intervention(Beta=-0.293),gender(Beta=0.292),and operation duration(Beta=0.271).Conclusion:1.The large amount of hidden blood loss in perioperative period is one of the main causes of anemia in senile patients after hip fracture surgery;2.The senile female patients with hip fracture are significantly more than male,but the perioperative hidden blood loss is lower in female patients than in male patients;3.Perioperative hidden blood loss of the GardenⅢandⅣfemoral neck fracture patients are more than intertrochanteric fractures,but joint replacement surgery way or PFNA has nothing to do with the hidden blood loss.4.The length of operation is positively correlated with the amount of hidden blood loss during perioperative period in senile patients with hip fracture;5.The curative effect of Jiawei Taohong Siwu Tang of Chinese medicine on preventing and treating perioperative hidden blood loss in senile patients with hip fracture is satisfactory.