Analysis of perioperative blood loss by fast track protocol in cephalomedullary nailing for geriatric intertrochanteric fractures

Objective: To analyze the effectiveness of fast track protocol of geriatric intertrochanteric fracture on operative waiting time, operation time, perioperative blood loss, providing data support for clinical therapy. Methods: The clinical data of 240 elderly patients with intertrochanteric fracture admitted between January 2015 and December 2018 were retrospectively analyzed. They were divided into traditional protocol group (148 cases, group A) and fast track group (92 cases, group B). All patients were treated with closed reduction intramedullary nail (proximal femoral nail antirotation) surgery. There was no significant difference in gender, age, sides, fracture classification, fracture type, complications, the proportion of patients with more than 3 kinds of medical diseases, and the time from injury to admission between the two groups ( P>0.05). Analysis index included operative waiting time (hospitalization to operation time), operation time, percentage of operation performing in 48 and 72 hours, percentage of transfusion, changes of hematocrit (Hct) at different stage (admission, operation day, and postoperative 1, 3 days), blood loss by fracture and cephalomedullary nail, intraoperative dominant blood loss, total blood loss in perioperative period were recorded and compared. 结果: B 组患者术前等待时间、手术时间、手术当天和术后 3 d Hct、骨折出血量、输血量及围术期总体失血量均显著少于 A 组，48 h 和 72 h 手术完成率显著高于 A 组，差异有统计学意义（ P 0.05）。. 结论: 绿色通道的开展能有效降低老年股骨转子间骨折术前等待时间、骨折失血量和围术期总体失血量，减少输血量，早期手术利于改善患者围术期贫血状态。.