| Objective:Subjects took self-made Huayu zhixuetang and warfarin in peri-operation period and then experimenter observed the clinical effect of perioperative hemorrhage volume and postoperative hemorheological behavior in artificial hip jiont replacement.Research is:(1)How did it effected the bleeding volume in operation and draining volume after operation,as subjects took self-made Huayu zhixuetang and warfarin in peri-operation period.(2)How did Huayu zhixuetang effected the Hb,RBC,PLT,PT,INR,APTT before and after operation.(3) How did Huayu zhixuetang effected the postoperative hcmorheological behavior and blood viscosity.(4)To investigate the effect of Huayu zhixuetang with abnormal thrombogenesis and check it's safety.To discuss the effect of Huayu zhixuetang in reducing bleeding volume in operation,postoperative drainage volume and improving blood circulation and viscosity state after operation,and so it may improve the patient's condition after surgery and prevent postoperative deepvein thrombosis(deepvenous thrombosis,DVT).The investigation will provid faithful data to surgical hemostasis.At the same time it will seek more secure and effective prevention DVT after artificial hip jiont replacement.And also it will be beneficial to the development of our country's traditional Chinese medicine.Methods:There are 63 patients in this group,in which 29 patients are male and 34 are female, and they are 36 years to 82 years that is 73.3 in average.All cases that are patients of 2006-2008 were collected from orthopaedic department of Affiliated Hospitals of Putian Institute.There cardiorespiratory function is normal and haven't hepatosis,renal functional disturbance and blood clotting systemic diseases.The preoperative value of Hb is above 100g/L and blood plate is normal.They are all the patients of artificial hip jiont replacement which are operated in a selective time.The experiment adopts the random and lot drawing method.According to the sequence of hospitalized time,All patients receive their corresponding drug.There collect 73 patients,in which 5 patients are poor compliance,1 patient is suspended operation,3 patients are early discharge thar test result could not continue.This nine patients were excluded.Finally a total of 63 cases of patients receive the test.They participated in the experiment voluntarily and were randomly divided into 2 groups:the TCM group which is 31 cases and the control group which is 32 cases.The patients of TCM group take Huayu zhixuetang(bid.,100ml every time) before 3 day of preoperative, bul control group take self-made Brown sugar water(bid.,100ml every time).They do not take drug in the day of operation.The patients of TCM group begin to take Huayu zhixuetang after 6h of anaesthesia awake,but control group take warfarin(2.5mg.qd). Application is same of preceding way and this situation is remainiug 12 day.To stop using the medicine that would effect the blood clotting and bleeding volume in the procedure.To draw the patients's venous blood before 2h of overdose and after 2d and 11d of postoperative.To determin HB,RBC,PLT,PT,INR,APTT and hemorheology.To calculate bleeding volume in operation and postoperative drainage volume of 6h,24h,48h.To observe tumefaction of patients' lower limbs.According to the DVT diagnostic criteria,the highly suspected patients of deep vein thrombosis will immediately use non-traumatic color doppler ultrasound for inspection,and calculate the incidence of postoperative DVT.To check the patients with or without bleeding of wound and subcutaneous hemorrhage of injection site,as well as other signs of bleeding, and closely observe whether have drug allergies and other adverse reactions.All data used SPSS14.0 for windows software package for statistical analysis.Results:1,Two groups patients are not striking different on age,gender,location,type of disease, type of surgery and anesthesia,phantom fixation(P＞0.05).2,In analysis of blood cells:HB,RBC,the inter-and intra-groups before 2th of overdose and after 2d are significantly different(P＜0.01) and in 11 days after surgery are significantly improved which compared with the control group are also difference (P＜0.01).TCM group on PLT before 2h of overdose and after 2d is only with statistical significance(P＜0.05)and in 11 days after surgery is no significant difference(P＞0.05), which comparcd with the control group is significant difference(P＜0.01).3,In analysis of blood coagulation function:PT,INR,APTT,the inter-and intra-groups on PT,APTT before 2h of overdose and after 2d are significantly different(P＜0.01 or P＜0.05).The control group on INR before 2h of overdose and after 2d is no significant difference(P＞0.05) and in 11 days after surgery is significant difference(P＜0.01) which was significantly prolonged.The control group on APTT in 2d vs.11d after surgery is only with statistical significance(P＜0.05).The three indexes in 11 days after surgcry in TCM group are significantly improved.4,In analysis of hemorheology,all values of patients in two group are significantly incrcascd,suggesting that a high blood coagulation,blood condition,in which the whole-blood viscosity at low,medium and high shear,the blood plasma viscosity,crythrocytc aggregation index and fibrinogen compared with the preoperative are significant difference(P＜0.05,P＜0.01).In 11 days after surgery all values of hemorhcology are significantly improved.The TCM group that compared with the control group are significant differences(P＜0.01).5,The TCM group of bleeding volume in operation and postoperative drainage volume of 6h,24h,48h are significantly less than the control group.The two group are differences(P＜0.05).The amount of average hemorrhage are 159.49ml.The amount of average drainage volume of 6h,24h,48h is respectively 88.93,22.33 ml和20.48 ml.The average amouut of blood transfusion is 0.66U.6,According to the circumferences of the different parts of the lower extremity in 3 days after surgery and referencing evaluation Standards of swelling,the cases of the TCM group's lower limbs tumefaction are significantly less than the control group's. The two group are differences(P＜0.05).7,There are 63 patients in this group,in which 2 cases occurr DVT(non-traumatic color doppler ultrasound for inspection confirmed).Two cases are the control group's and the rate is 6.25 percent.No pulmonary embolism or death occurred.There is 0 case in the TCM group that DVT occurred.The two group are no differences(P＞0.05).8,There are 63 patients in this group,in which 14 cases occurr hemorrhage signs.There are 14 cases in the TCM group with rate of 37.50 percent.These patients are suspended warfarin treatment and symptoms ease.There are 2 cases in the control group and these patients are without special treatment and symptoms ease.The two group are significant differences(P＜0.01).All the patients had no drug allergies and other adverse reactions.Conclusion:Self-made Huayu zhixuetang can significant reduce bleeding volume in operation,postoperative drainage volume,shorten PT,APTT,increase platelet counts,so it have good effects on surgical hemostasis,and also improve blood circulation and viscosity state after operation and so as to reduce the clinical symptoms and signs.This bidirectional regulation of drug treatment for the surgeon and surgical in solving the problem of surgical bleeding and preventing DVT after artificial hip jiont replacement opens up a new way.And also it will be beneficial to the development of our country's traditional Chinese medicine.
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