桃红四物汤联合氨甲环酸对人工股骨头置换术后隐形失血的影响

Effect of Taohong Siwu Decoction Combined with Tranexamic Acid on Invisible Blood Loss after Artificial Femoral Head Replacement

目的探讨桃红四物汤联合氨甲环酸对人工股骨头置换术后隐性失血的影响。方法选取2017年3月~2018年10月我院行人工股骨头置换的股骨颈骨折老年患者58例,随机分为对照组32例和中药组26例。对照组采用利伐沙班+氨甲环酸治疗,中药组在对照组的基础上加用桃红四物汤治疗。对比两组患者输血率、隐性失血量、术后肿胀情况及并发症情况。结果中药组与对照组输血率比较(15.38%vs12.50%)、隐性失血量比较[(38.25±5.21)mlvs(40.12±6.14)ml],差异无统计学意义(P>0.05)。两组术后第1天、第10天、第14天患肢肿胀情况比较,差异无统计学意义(P>0.05)。中药组术后第3天肿胀变化为(41.02±4.96)mm,小于对照组的(56.56±5.26)mm,第7天肿胀变化为(22.08±3.90)mm,小于对照组的(30.54±6.11)mm,差异均有统计学意义(P<0.05)。两组患者术后3个月内随访,未发生肺栓塞及下肢深静脉血栓。结论桃红四物汤作为活血化瘀代表方与氨甲环酸合用,不增加患者出血及输血风险,并具有促进术后消肿的优势。

Objective To investigate the effect of Taohong Siwu Decoction combined with tranexamic acid on recessive blood loss after artificial femoral head replacement.Methods A total of 58 elderly patients with femoral neck fracture who underwent artificial femoral head replacement from March 2017 to October 2018 were randomly divided into control group(n=32)and Chinese medicine group(n=26).The control group was treated with rivaroxaban+tranexamic acid,and the Chinese medicine group was treated with Taohong Siwu Decoction on the basis of the control group.The transfusion rate,recessive blood loss,postoperative swelling and complications were compared between the two groups.Results The blood transfusion rate of the Chinese medicine group and the control group were compared(15.38%vs 12.50%)and the recessive blood loss was compared([38.25±5.21)ml vs(40.12±6.14)ml],the difference was not statistically significant(P>0.05).There was no significant difference in the swelling of the affected limbs on the 1st,10th,and 14th day after operation(P>0.05).The swelling of the Chinese medicine group on the 3rd day after surgery was(41.02±4.96)mm,which was smaller than that of the control group(56.56±5.26)mm,and the swelling change on the 7th day was(22.08±3.90)mm,which was smaller than that of the control group(30.54±6.11)mm,the difference was statistically significant(P<0.05).Two groups of patients were followed up within 3 months after surgery,and no pulmonary embolism and deep venous thrombosis of the lower extremities occurred.Conclusion Taohong Siwu Decoction,as a representative of Huoxuehuayu and tranexamic acid,does not increase the risk of bleeding and blood transfusion,and has the advantage of promoting postoperative swelling.