Research Of The Relationship Between The Hidden Blood Loss After Total Knee Arthroplasty And The Traditional Chinese Medicine Constitution

ObjectiveOsteoarthritis is one of the most common causes of total knee arthroplasty (TKA), which can alleviate pain, correct limb alignment, and improve the quality of life. However, there is significant hidden blood loss after TKA, but its mechanism is unknown. As one research hotspot, Traditional Chinese medicine (TCM) constitution theory is one discipline aiming to study the physical characteristics, as well as the physiological and pathological features of humans. This research aimed to investigate the relationship between TCM constitution types and hidden blood loss after TKA.Methods94cases of patients who received TKA between2011.01and2014.01were selected, in which7cases were excluded. The87actual effective cases were typed according to the "Chinese constitution dialectical" issued by Chinese Medical Association in2009. Total blood loss and hidden blood loss, as well as preoperative and postoperative changes of hemoglobin were calculated. Meanwhile, all the patients were grouped according to whether placing drainage pipes and the drainage ways.ResultsIn all patients, gentleness10cases, accounting for12.82%; biased mass77cases, accounting for87.18%. Among them, the yang and yin deficiency and blood stasis, yin deficiency and blood stasis and heat, as well as phlegm and blood stasis and yang deficiency, accounting for20.69%,19.23%,12.82%respectively. Blood stasis, yang deficiency, and yin deficiency patients had more total blood loss than the damp-heat, phlegm-damp, and gentleness patients (P<0.01or0.05); while total blood loss of damp-heat and phlegm-damp group were significantly greater than gentleness patients (P<0.01or0.05). On the hidden blood loss ratio, the blood stasis group was significantly greater than the other groups (P<0.01or0.05), as well as gentleness group were significantly smaller than the other groups (P<0.01or0.05). Meanwhile, the total blood loss of patients with natural drainage tube was significantly greater than patients with drainage4hours surgery and patients without drainage, while its hidden blood loss ratio is significantly less than the other two groups.ConclusionTKA postoperative blood loss and hidden blood loss were all related with type of TCM constitution. Total blood loss and hidden blood loss volume in patients with blood stasis is larger, and that of yang and yin deficiency of patient followed, as well as that of gentleness patients were smaller. In addition, the placed drainage tube could increase the total amount of blood loss, but at the same time reduce the amount of hidden blood loss.