The effect of perioperative blood protection measures on rapid recovery of elderly patients undergoing total hip arthroplasty
Objective To explore the effect of perioperative blood protection measures on rapid recovery of elderly patients undergoing total hip arthroplasty.Methods 120 elderly patients undergoing elective total hip arthroplasty were selected as the study subjects and randomly divided into a regular care group and an autologous blood transfusion(ABT)+controlled hypotension(CH)group,with 60 patients in each group.The regular care group received routine intraoperative treatment,while the ABT+CH group received intraoperative ABT combined with CH.Both groups were compared in terms of blood cell related indicators[hemoglobin(Hb),hematocrit(Hct),platelet count(PLT)],inflammatory response indicators[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8),S-100β protein,neuron-specific enolase(NSE)],Mini-Mental State Examination Scale(MMSE)score,Harris hip function score,rehabilitation related time indicators.Results 7 d after surgery,ABT+CH group had Hb of(122.25±7.02)g/L,Hct of(37.25±7.63)%,and PLT of(3.72±0.96)×109/L,which were significantly higher than(105.56±11.36)g/L,(31.25±6.89)%,and(2.53±1.13)×109/L in regular care group(P<0.05).The levels of TNF-α,IL-1β,IL-6,IL-8,S-100β protein and NSE in ABT+CH group were significantly lower than those in regular care group immediately after surgery,1 d after surgery and 7 d after surgery(P<0.05).MMSE scores of ABT+CH group were(24.13±3.56)and(25.01±4.86)points 1 and 7 d after surgery,which were significantly higher than(22.03±4.02)and(22.81±2.76)points of regular care group(P<0.05).The Harris hip function scores were(85.26±7.12)and(90.25±8.17)points in ABT+CH group 1 and 3 months after surgery,which were significantly higher than(76.39±9.17)and(82.25±7.56)points in regular care group(P<0.05).The postoperative ambulation time,the time of weight bearing on the affected limb and the time of hospitalization in ABT+CH group were(3.36±1.25),(6.25±1.14)and(9.25±1.68)d,which were significantly shorter than(5.18±1.75),(7.89±1.35)and(12.03±2.16)d in regular care group(P<0.05).Conclusion ABT combined with CH is a reliable perioperative blood protection measure that improves the postoperative recovery speed of patients and has a reliable application effect.
Perioperative periodBlood protection measuresOld ageTotal hip arthroplastyRapid recoveryCognitive function
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