| ObjectiveIn this study, total knee replacement (Total Knee Arthroplasty TKA) patients in the intraoperative and postoperative hemostatic (tranexamic acid (Tranexamic Acid TXA)) to assess and evaluate the recessive recessive bleeding on postoperative bleeding (Hidden Blood Loss HBL) impact and safety. At the same time the use of total knee replacement patients after Huoxuehuayu prevention of deep vein thrombosis (Deep Vein Thrombosis DVT), to assess their impact on postoperative hidden blood loss and safety, for the traditional Chinese medicine in perioperative artificial joints the application period to provide evidence.MethodsA randomized controlled study design selection of knee osteoarthritis patients met the inclusion criteria and patients in our hospital a total of 90 cases of unilateral TKA as an object of study. Group A:traditional Chinese medicine group,30 cases; Group B:blood circulation combined with tranexamic acid in the treatment group,30 cases; Group C:control group,30 cases. Three groups of patients with an operation performed by the same surgeon, after three groups of patients underwent the same rehabilitation exercise program, about two weeks after surgery were discharged. Patients condition before surgery, will quantify data, and then analyze three cases of preoperative condition information by using SPSS17.0 statistical software, sample homogeneity comparison, if the analysis results suggest that the three groups of patients in the preoperative condition data comparable, on further analysis of group-A and group B data, total blood loss, blood loss was dominant, recessive blood loss, transfusion rates, length of stay, deep vein thrombosis and bleeding complications Event Have significant difference; A group Compared with group C, the total blood loss, blood loss was dominant, recessive blood loss, transfusion rates, length of stay, ecchymosis rates and the presence or absence of bleeding complications statistically significant.ResultsAfter statistical analysis, patients with three groups of patients gender, age, knee side, height, weight, BMI (Body Mass Index BMI), age group (less than 60 years old or more than 60 years), preoperative Hss score, surgical incision, operation time, preoperative hemoglobin, preoperative Hct, preoperative D-dimer, with medical diseases (hypertension, diabetes, high blood pressure and diabetes, no high blood pressure and diabetes) and other information were not statistically difference (P> 0.05), three sets of data comparable.All cases of blood loss percentage:Dominant blood loss percentage:27.70 ±11.35%; hidden hemorrhage percentage:72.38±11.26%. A group, A group A and group C two control groups with group B, found that the percentage of dominant and recessive blood loss percentage of blood loss was no significant difference (P> 0.05). Description With tranexamic acid or the percentage of traditional Chinese medicine and the percentage of hidden blood loss had no effect on blood loss after TKA dominant. According perioperative monitoring of blood, and found that the average hemoglobin and Hct lowest point after the three groups focused on the third day, basically flat trend after the seventh day.Comparative effect of tranexamic acid on hidden blood loss after TKA found in group B than in group A mean reduction in total blood loss after 211.86ml, hidden hemorrhage average reduction 160.28ml, reduce the number of days in hospital on average 2.4 days less, (P<0.05), the difference was statistically significant. But for postoperative drainage, transfusion rate and ecchymosis rate impact was not significant. And study DVT events were not there. Description tranexamic acid can effectively reduce the amount of blood loss after TKA, hidden blood loss and length of hospital stay, and the security is good.Comparison of blood circulation effect of Chinese medicine on hidden blood loss and total blood loss Huoxuehuayu than the control group, the average increase 225.69ml, an average increase of hidden blood loss 167.66ml, (P<0.05), the difference was statistically significant. But for a few days in hospital, postoperative drainage, transfusion rate and ecchymosis Rate not statistically significant. And the study were not there DVT events and massive blood loss complications. Description traditional Chinese medicine in a good preventive DVT after TKA same time, increase the amount of blood loss after TKA.ConclusionAccording to the results it found hidden hemorrhage occupy the vast majority of blood loss after TKA. Postoperative hemoglobin and Hct lowest value mainly in the third postoperative day. Tranexamic acid can significantly reduce perioperative blood loss and reduce the number of days of hospitalization, and did not increase the risk of DVT, it tranexamic acid is safe and effective, is a worthy controlling perioperative blood loss drugs. Chinese Herbs in a good preventive TKA postoperative venous thromboembolic events, while increase the amount of blood loss after TKA, hidden blood loss. So the use of traditional Chinese medicine at the same time need to closely monitor the patient hemoglobin, replenish the hidden blood loss due to decreased blood volume. |
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