The Effect Of Modified Angelica Blood-supplementing Decoction Combined With Tranexamic Acid On Latent Blood Loss After Total Hip Replacement

Objective: To observe the effect of oral modified angelica Buxue decoction combined with trantranic acid injection before surgery on the invisible blood loss after total hip arthroplasty for the elderly with femoral neck fracture,and to explore the efficacy and safety of Chinese prescription modified angelica Buxue decoction on the invisible blood loss after surgery.Methods: From January 2022 to January 2023,patients undergoing total hip replacement due to femoral neck fracture in the Department of Bone and Limb,Airport Hospital of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine were selected.According to the inclusion and exclusion criteria,50 patients were included as research objects and divided into observation group and control group according to different treatment methods,with 25 cases in each group.The observation group was given tranexamic acid injection before surgery,and oral administration of Chinese herbal decoction supplemented with angelica blood-tonifying decoction began on the first day after surgery,and continued to take 14 days until the stitches were removed and discharged.The control group was not given oral Chinese medicine,and both groups were treated with anti-infection,detumescence and pain relief,anticoagulation and fluid replenishment after surgery.Gender(male/female),age(years),height(m),weight(kg),BMI index,affected side(left/right),hemoglobin(HB),hematocrit(HCT),intraoperative blood loss,postoperative drainage volume and dominant blood loss of the two groups were recorded and compared.Preoperative and 1 week after surgery,D-dimer(D-D),arteriovenous color ultrasound of lower limbs,TCM syndrome scores at1,7 and 14 days after surgery and the efficacy of TCM syndrome were obtained.The recessive blood loss at 1,7 and 14 days after surgery was calculated and compared between the two groups by the formula,and the influence of modified angelica Buxed-blood decoction combined with trantranic acid on the recessive blood loss after total hip replacement was evaluated.Results: There were no significant differences in gender(male/female),age(years),height(m),weight(kg),BMI index and affected side(left/right)between the two groups(P > 0.05),indicating comparability.There was no significant difference in intraoperative blood loss,postoperative drainage volume and dominant blood loss between the two groups(P > 0.05).There was no significant difference in HB,HCT and recessive blood loss between the observation group and the control group on day 1 after surgery(P > 0.05).HB,HCT and recessive blood loss on the 7th and 14 th day after surgery were significantly different from the control group(P < 0.05),and the observation group was better than the control group.On the first day after surgery,there was no significant difference in TCM syndrome scores between the two groups(P > 0.05).On the 7th and 14 th day after surgery,the difference between the two groups was statistically significant(P < 0.05),and the observation group was better than the control group.There was no significant difference in D-dimer(D-D)between 2 groups before surgery and 1 week after surgery(P > 0.05),no obvious abnormality was observed in arteriovenous ultrasonography of lower limbs before surgery and 1 week after surgery,and no obvious adverse reactions were observed in 2 groups.Conclusions: It can be seen that modified angelica blood-supplementing decoction combined with tranatemic acid can effectively reduce postoperative recessive blood loss,HB and HCT loss,accelerate the recovery of qi and blood deficiency in patients after total hip replacement,promote early postoperative functional exercise to a certain extent,and fit the concept of rapid recovery.