Regularity of hidden blood loss before repair of closed femoral shaft fractures

doi:10.3969/j.issn.2095-4344.2014.53.018

Abstract

Abstract:

BACKGROUND: The timing of surgery, postoperative functional exercise and prognosis are strongly associated with hidden blood loss. Therefore, clinical orthopedics pays more and more attention on hidden blood loss after fracture. Hidden blood loss that cannot be ignored exists during perioperative fracture repair, which has been investigated by many studies. Hidden blood loss before repair has been seldom investigated.
OBJECTIVE: To observe the regularity of hidden blood loss so as to precisely understand the changes of illness and blood loss and to treat anemia in time by blood routine examination before repair in patients with unilateral closed femoral shaft fracture.
METHODS: A total of 50 patients with unilateral femoral shaft fractures were selected from March 2013 to March 2014, including 27 males and 23 females. There were 21 cases in the elderly group (≥ 60 years) and 29 cases in the non-elderly group (< 60 years). Fasting blood was extracted in the morning after admission for blood routine examination. Hemoglobin and hematocrit were recorded at 1-6 days before repair. Average decreasing degree and the time of minimum value appearance of hemoglobin and hematocrit were observed every day. Blood loss was known.
RESULTS AND CONCLUSION: The everyday blood routine index (hemoglobin and hematocrit) in 50 patients with femoral shaft fractures after admission has certain regularity. The lowest hemoglobin and hematocrit appeared at 5 days. The difference between the first-day and fifth-day was separately 10.08% and 34.66 g/L. The routine blood index declined gradually from the first day to fifth day. The lowest value appeared on the fifth day, and the highest value appeared on the sixth day. The difference of the first day value and the fourth day value was the maximum difference of blood routine index in the elderly group. The hemoglobin d1-4 was 38.84 g/L and the hematocrit d1-4 was 11.86%. The amount of blood loss was 1 335.3 mL. The difference of the first day value and the fifth day value was the maximum difference of blood routine index in non-elderly group. The hemoglobin d1-5 was 30.42 g/L and the hematocrit d1-5 was 9.23%. The amount of blood loss was 1 073.7 mL. The difference of blood routine index between elderly group and non-elderly group decreased gradually from the fifth day and the sixth day. Significant differences in blood routine indexes were detected between elderly group and non-elderly group (P < 0.05). The amount of hidden blood loss in the elderly group was significantly greater than that in the non-elderly group. The amount of hidden blood loss was more in patients with femoral shaft fractures before repair. Routine blood index detected on the first day cannot reflect the amount of blood loss immediately. Blood routine index decreased gradually along with the increase of the hospitalized days. Simultaneously, blood loss in the elderly group was more than that in the non-elderly group. Moreover, the speed of blood loss was fast. Therefore, hidden blood loss should be heeded in femoral shaft fractures. Blood routine indexes should be regularly reviewed. Measures should be used to correct the anemia so as to reduce the preoperative and postoperative complications.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: femoral fractures, blood loss, surgical, hemoglobins, hematocrit

CLC Number:

R318

Wang Li-wei, Wang Hong-bing, Yan Jin-cheng, Zhang Kai, Gu Xue-jian, Li Chang-jiang, Shi Fu-dong. Regularity of hidden blood loss before repair of closed femoral shaft fractures[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(53): 8623-8628.

Figures/Tables 5

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