The Effect Of Yiqi Buxue Decoction On The Hidden Blood Loss After Total Hip Replacement

ObjectiveTotal hip replacement(THR)is a hip surgery which has massive bleeding and high allogeneic transfusion rate and other complication duringperioperative period.Recently humans found that the hidden blood loss during perioperative period can not be ignored,which had serious influence including postponed wound healing,extended stage of recovery,increased allogeneic blood transfusion rate,prolonged bedtime,serious risk of deep venous thrombosis.This study combined with the theory of Chinese medicine and used Yiqi Buxue decoction for the treatment of hidden blood loss.It aims to evaluate the effect and safety of hidden blood loss after THR and to provide theories in the treatment of artificial joint replacement with Yiqi Buxue decoction.MethodsWe selected 60 patients of orthopedics ward of Panyu Hospital of Chinese Medicine during February 2016 to February 2017.The patients were divided into treatment group and control group according to the ratio of 1:1.The two groups were treated with THR surgery.The treatment group underwent THR surgery combined with Bazhen decoction through the mouth,the control group only underwent THR surgery.In the meantime,we recorded the two groups of patients with gender,age,height,weight,preoperative and postoperative blood,Harris score and other datas.The hidden blood loss was calculated according to Gross and Nadler equation,and finally we analysed indexes and compared clinical efficacy between the two groups.ResultsThere was no significant difference in RBC,HGB and HCT on preoperative day,operation day,postoperative 1 days between the two groups(P>0.05).On postoperative 3 days and postoperative 7 days,RBC,HGB and HCT were different(P<0.05),the treatment group higher than the control group,and the RBC,HGB and HCT of the two groups mostly reached minimum time on the third day after operation,which indicating that Bazhen decoction could elevate RBC,HGB,HCT on the postoperative 3 days and postoperative 7 days.There was no significant difference in blood transfusion rate and dominant blood loss between the two groups(P>0.05).But the hidden blood loss had statistical difference between the two groups(P<0.05),the treatment group lower than the control group,revealing Bazhen decoction can reduce the amount of hidden blood loss during THR perioperative period,but can not effectively reduce the dominant blood loss and blood transfusion rate.On the 14th day after operation,the Harris score of the hip was significantly higher than the 7th day after operation(P<0.01).The Harris score of the hip in the treatment group was significantly higher than that in the control group on the 7th day and the 14th day after operation(P<0.01),indicating that Bazhen decoction can accelerate functional rehabilitation after THR.ConclusionHidden blood loss is a common phenomenon with THR,and the RBC,HGB and HCT are significantly decreased after THR,and the minimum time occurs on the third day after operation.Yiqi Buxue decoction(Bazhen decoction)can elevate RBC,HGB,HCT on the postoperative 3 days and postoperative 7 days,reduce he hidden blood loss,accelerate postoperative functional rehabilitation without severe adverse reactions,which is worthy of clinical application in the treatment of artificial joint replacement.