髋部骨折围手术期隐性失血与血瘀证相关性研究

Correlation study between hidden blood loss and blood stasis syndrome at perioperative period of hip fracture

目的探索髋部骨折围手术期隐性失血与血瘀证的相关性,为隐性失血的证候研究提供依据。方法采用证候研究的方法,对40例符合纳入标准的患者进行研究。根据定量血瘀证诊断标准记分方法,于术后1 d和术后3 d对患者的血瘀证症状进行定量积分,同时计算患者术后1 d和术后3 d的隐性失血量。根据血瘀证积分结果将患者分为轻度血瘀证、中度血瘀证和重度血瘀证3个组别,运用Pearson线性相关分析,观察隐性失血量与血瘀证积分是否具有相关性,运用单因素分析法观察组间隐性失血量有无统计学差异。结果术后1 d与术后3 d,40例患者隐性失血量与血瘀证积分呈正相关(P<0.05),即血瘀证积分越高,隐性失血量越大(P<0.05)。随时间变化隐形失血量与血瘀证积分均呈升高的趋势(P<0.05)。结论髋部骨折围手术期隐性失血与血瘀证具有正相关性,提示血瘀证是隐性失血的主要病机之一。

Objective To provide evidence for the study of the syndrome differentiation of hidden blood loss by analyzing the relationship between hidden blood loss and blood stasis syndrome at perioperative period of hip fracture. Methods By the methods of syndrome study,40 patients that meeting the standards of case selection criteria were included in this study. According to the standard scoring method for diagnosis of blood stasis syndrome,the symptom of blood stasis was quantified on the 1st and 3rd day after operation. At the same time,the volume of hidden blood loss was calculated on the 1st and 3rd day after operation. According to the scoring of the blood stasis syndrome,the patients were divided into 3grades of mild blood stasis syndrome,moderate blood stasis syndrome and severe blood stasis syndrome.To observe whether hidden blood loss and blood stasis integral had correlation through the Pearson correlation analysis. Using the single factor analysis to observe whether there was significant difference between the volume of hidden blood loss in different groups. According to the statistical results,the relationship was discussed between blood stasis syndrome and hidden blood loss during perioperative period of hip fracture. Results The 1st day and 3rd day after operation,the hidden blood loss and blood stasis syndrome integral were positively correlated（ P〈0. 05）,and the higher the blood stasis score,the more the hidden blood loss（ P〈0. 05）. The volume of hidden blood loss and blood stasis score gradually increase over time（ P〈0. 05）. Conclusion Between the volume of hidden blood loss and blood stasis syndrome during perioperative period in hip fracture have positive correlation,which indicates blood stasis syndrome is one of the main pathogenesis of hidden blood loss.