当归补血汤与多聚糖止血材料治疗全髋关节置换术后隐性失血临床疗效对比

Comparison of Clinical Efficacy of Danggui Buxue Decoction and Polysaccharide Hemostatic Material in the Treatment of Hidden Blood Loss After Total Hip Arthroplasty

目的:观察当归补血汤与多聚糖止血材料治疗全髋关节术后隐性失血的临床疗效对比。方法:选取2022年1月-2023年3月于成都中医药大学附属医院行全髋关节置换术的患者60例,采用计算机生成随机数字表的方法将患者分为当归补血汤组(DG组)和多聚糖止血材料组(DJ组),每组各30例,DG组术后第1天开始口服当归补血汤,DJ组在术中使用多聚糖止血材料。比较两组患者术后第1、3、7、14天的红细胞比容(HCT)、血红蛋白(Hb)及术后24 h引流量、术后隐性失血量、中医证候症状评分。结果:术后24 h引流量DJ组低于DG组,差异具有统计学意义(P<0.05);两组术后隐性失血量,DG组显著低于DJ组(P<0.05);DG组术后第3天中医证候症状评分及第1、3天的HCT、Hb与DJ组差异无统计学意义(P>0.05),DG组术后第7天中医证候症状评分及第7、14天HCT、Hb显著低于DJ组(P<0.05)。结论:多聚糖止血材料术后短时间内止血效果优于当归补血汤,但从隐性失血量减少和中医证候症状改善来看,当归补血汤组的效果优于多聚糖组,且当归补血汤组能显著提高患者HCT及Hb的水平,明显改善术后患者贫血状态,临床效果明显。

Objective:To observe the clinical effect of Danggui Buxue decoction and polysaccharide hemostatic material in the treatment of hidden blood loss after total hip arthroplasty.Methods:60 patients who underwent total hip arthroplasty in Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2022 to March 2023 were selected,and the patients were divided into Danggui Buxue decoction group(DG group)and polysaccharide hemostatic material group(DJ group)with 30 cases each by computer generated random number table.In DG group,Danggui Buxue decoction was taken orally on the first day after surgery.In the DJ group,polysaccharide hemostatic materials were used during the operation.Hematocrit(HCT),hemoglobin(Hb),drainage volume 24 hours after surgery,hidden blood loss and TCM syndrome symptom scores were compared between the two groups at the 1st,3rd,7th and 14th day after surgery.Results:The drainage volume 24 hours after operation in DJ group was lower than that in DG group,and the difference was statistically significant(P<0.05).Postoperative hidden blood loss in DG group was significantly lower than that in DJ group(P<0.05).TCM syndrome symptom score on the 3rd day after surgery and HCT and Hb on the 1st and 3rd day in DG group were not significantly different from those in DJ group(P>0.05).TCM syndrome symptom score on the 7th day after surgery and HCT and Hb on the 7th and 14th day in DG group were significantly lower than those in DJ group(P<0.05).Conclusion:The hemostatic effect of the polysaccharide hemostatic material is better than that of Danggui Buxue decoction in the short time after surgery.However,from the perspective of the reduction of hidden blood loss and the improvement of TCM syndrome symptoms,the effect of Danggui Buxue decoction group is better than that of the polysaccharide group,and the Danggui Buxue decoction group can significantly improve the levels of HCT and Hb of patients,and significantly improve the anemia status of patients after surgery,with obvious clinical effect.