Clinical Research On Prevention Act Jianpi Huoxue Total Knee Arthroplasty Anticoagulant Bleeding Risk

Objective: Using controlled clinical studies, by observing the spleen and activating blood total knee arthroplasty in the prevention of postoperative anticoagulant blood loss of clinical efficacy and safety evaluation, and explore its mechanism of action, trying to Jianpi Huoxue artificial total knee Prevention Act arthroplasty of deep vein thrombosis(DVT) after formation and reduce the risk of hemorrhagic complications of anticoagulation provide theoretical and clinical basis.Methods: Select Hospital of Henan Province joint department since April 2014-2014 October 60 cases of unilateral TKA patients. Randomly divided into two groups, surgical techniques and postoperative other treatment the same average operative time was(58.31 ± 7.36) min. The first day of the treatment group were given oral medicine combining Jianpihuoxuetongluo class rivaroxaban 10 mg, qd, po prevent DVT formation; the control group after the first day of the simple use of rivaroxaban 10 mg, qd, po prevention. In comparing the two groups of gender, age, height, weight, and other general information on the course, the difference was not statistically significant(P> 0.05), comparable. Two groups of patients preoperative preparation, postoperative medication are the same, all done by the same group of doctors surgery and shoving as much as possible to ensure the consistency of surgical operations. Two groups of patients before surgery and three days after the first line of blood tests, according to the formula to calculate the total amount of blood loss; record intraoperative blood loss, postoperative wound drainage and post-extubation wound exudate amount, calculate the dominant blood loss, and to observe whether the wound hematoma formation and mucocutaneous bleeding; Preoperative and postoperative day 3, the first 10 days of hemoglobin(HGB) decreased amount, platelet count, prothrombin time(PT), activated partial thromboplastin Time(APTT) and D- dimer, thigh circumference change values; eight days after the first review of the double venous color Doppler ultrasound clear whether thrombosis, DVT formation evaluation and postoperative incidence of DVT. By comparing the two major efficacy, safety index of spleen and activating blood in the fight to get total knee replacement surgery in anticoagulated blood loss of efficacy and safety.Results: 1, the two groups of patients preoperative hemoglobin concentration, platelet count, prothrombin time, activated partial thromboplastin time, There were significant differences(P <0.05 or P <0.01) D-Ⅱ mer and postoperative; 2, D-Ⅱ mer in the first 10 days after the performance indicators for the treatment group was significantly lower than the control group(P <0.05); 3, the total amount of blood loss in patients treated with postoperative blood loss and dominant than the control group, high postoperative hemoglobin concentration in the control group, and the differences were statistically significant(P <0.05); 4, two groups of patients were compared with preoperative lower limb circumference increased in the treatment group on day 3 thigh circumference that is returned to the preoperative state, gifted There was no significant difference in 5 patients with clinical symptoms of both groups before and after treatment, comparing patients treated after signs of limb pain, tenderness femoral triangle, Homans sign(+) the disappearance rate with the control group(P; in the control group(P <0.05) > 0.05); 6, the first eight days after the two groups of patients after venous ultrasound confirmed a total of three cases of deep vein thrombosis found one case in which the treatment group and the control group 2 cases, there was no statistically significant difference between groups(P> 0.05).Conclusions: Patients after total knee arthroplasty, the use of Jianpi Huoxue method combined with rivaroxaban and simple use of rivaroxaban compared to not only prevent the formation of postoperative DVT, but also reduce the amount of bleeding after surgery and reduce postoperative pain and swelling after surgery to eliminate also help. So that patients with early active rehabilitation exercises, reduce postoperative complications in patients, shorten hospital stays, improve health care efficiency, reduce blood transfusion, optimized medical resources. Clinical expected to provide a cost-effective use of drugs, to facilitate the promotion of effective anticoagulation after TKA.