| Objective : Total knee arthroplasty(TKA)has gradually become one of the most effective methods for the treatment of terminal knee diseases,but there are al so problems such as bleeding caused by surgical trauma.In addition to our visible blood loss,Posto Perative blood loss following the hidden impact is more and more aroused the attention of physicians,not only slow wound healing and hidden blood loss recovery of knee joint function,long time in the lower extremity deep venous thrombosis risk greatly increased.The subject is to observe the curative effect of zhi xue dan jia jian on recessive blood loss after TKA under the guidance of traditional Chinese medicine theory.Methods : According to the diagnosis,inclusion and exclusion criteria,40 patients who underwent primary unilateral total knee arthroplasty in Xu Chang ren he Department of orthopedics hospital from May 2017 to November 2017 were randomly divided into control group and Chinese medicine group according to the order of treatment.The control group: in 30 minutes before the release of the tourniquet given tranexamic acid 1g and 100 ml normal saline infusion,given conventional anti-inflammatory and anticoagulant therapy after surgery;traditional Chinese medicine group was given in the control group on the basis of zhi xue dan jia jian taking.Records of all Patients with gender,age,height,weight and other basic data,calculation on preoperative blood volume in patients with intraoperative blood loss for each record,and the amount of postoperative drainage,operative time and length of an excuse;two groups of patients in the preoperative,postoperative first,4,10 days measured hemoglobin and red blood cell hematocrit,the hidden blood loss was calculated,compared the clinical efficacy and changes in indicators,measuring the VAS score before and after surgery and HSS score,statistical analysis using SPSS22.0 analysis.Results : 1 Two groups of patients before operation sex,age,height,weight and preoperative hemoglobin(Hb)and hematocrit(HCT)contrast,no statistical significance(P > 0.05).2 Blood loss of two groups of patients,in the Chinese medicine group(218.95±48.19)m L and control group(224.00 ± 44.79)m L there was no statistically significant difference(P>0.05);postoperative drainage: Chinese medicine group(162.95±22.84)m L and control group(173.35±19.23)m L there was no statistically significant difference(P>0.05);significant blood loss: Chinese medicine group(381.90±55.54)m L and control group(397.15±47.70)m L there was no statistically significant difference(P> 0.05).3 Two groups of patients with hidden blood loss compared to the Chinese medicine group(455.73±165.30)m Lcompared with the control group(567.65±157.06)m L,the difference was statistically significant(P<0.05).4 First days after surgery,two patients with HCT and Hb is lower than before,compared between the two groups,Chinese medicine group than in the control group,P<0.05,there is significant difference between the two groups;fourth days after operation than before were decreased,compared with two groups,Chinese medicine group than in the control group,P<0.05.There was statistical difference;tenth days after operation,two groups compared with the fourth day increased,compared with two groups,Chinese medicine group than in the control group,P<0.05,there was significant difference.5 Two groups of patients preoperative and postoperative first days VAS score,the difference was not statistically significant,P >0.05;in the control group fourth days and tenth days after operation,the VAS score was higher than that of the Chinese medicine group,P<0.05,the difference was statistically significant.6 Two groups of patients preoperative and postoperative fourteenth days HSS score compared,the difference was not statistically significant,P>0.05;in the control group fourth days and tenth days after operation,HSS score was lower than that of Chinese medicine group,P<0.05,the difference was statistically significant.Conclusion The use of zhi xue dan jia jian can reduce the amount of invisible blood loss after total knee arthroplasty,promote the recovery of HCT and Hb,and promote the early postoperative pain control and functional recovery. |
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