补气活血方联合氨甲环酸对膝关节置换术后贫血的观察

Clinical observation on treating anemia after knee arthroplasty with the Buqi Huoxue prescription plus tranexamic acid

目的:探讨补气活血方联合氨甲环酸(Tranexamic Acid,TXA)对单侧全膝关节置换术(Total Knee Arthroplasty,TKA)患者术后贫血的影响。方法:选取太和县中医院2018年1月-2020年2月住院治疗的膝关节炎40例,随机分为研究组和对照组,每组20例。两组患者均在行TKA术前10 min给予静脉滴注TXA 1 g,术后均放置引流管一根,逆行引流管注射TXA100 mL(1 g),引流管夹闭4 h,研究组在对照组基础上口服补气活血方治疗。观察两组患者术后总失血量、隐性失血量、显性失血量及输血量;术后3天、7天、10天血红蛋白及红细胞比容的变化。结果:两组患者围手术期总失血量比较,研究组显著少于对照组,差异有统计学意义(P <0.05);两组患者术中失血量比较,差异无统计学意义(P> 0.05);两组术后引流量比较,差异有统计学意义(P <0.05);两组患者隐性失血量比较,研究组显著少于对照组,差异有统计学意义(P <0.05);两组患者术后显性失血量,研究组与对照组的差异无统计学意义(P> 0.05);两组患者术后3天、7天、10天血红蛋白比较,研究组显著高于对照组,差异有统计学意义(P <0.05);两组患者术后3天、7天、10天红细胞比容比较,研究组显著高于对照组,差异有统计学意义(P <0.05)。结论:补气活血方联合TXA对膝关节置换术后贫血疗效确切,可明显降低患者术后失血量,值得推广使用。

Objective:To investigate the effect of the Buqi Huoxue prescription(补气活血方)plus tranexamic acid on anemia after unilateral total knee arthroplasty.Methods:Forty cases were selected and randomly divided into the study group and the control group,and 20 cases in each group.The patients in both groups were given intravenous infusion of TXA 1 g 10 minutes before TKA.After surgery,a drainage tube was placed,and 100 mL(1 g)of TXA was injected into the retrograde tube retrogradely.The drainage tube was clamped for 4 hours.The study group was also arranged to take the Buqi Huoxue prescription.Results:The total blood loss during perioperative period in the study group was significantly less than the control group(P<0.05).The difference of intraoperative blood loss between the two groups was not statistically significant(P>0.05).The difference of postoperative drainage volume between the two groups was statistically significant(P<0.05).The amount of hidden blood loss in the study group was significantly less than the control group,and the difference was statistically significant(P<0.05).The difference of apparent blood loss after surgery between the two groups was not statistically significant(P>0.05).The hemoglobin level on the 3rd,7th,and 10th days in the study group were significantly higher than the control group,P<0.05.The hematocrit level on the 3rd,7th and 10th days after the operation in the study group were significantly higher than the control group,and P<0.05.Conclusion:The Buqi Huoxue prescription plus TXA on anemia after knee arthroplasty shows a definite effect.It can significantly reduce postoperative blood loss,and is worthy of promotion.