Ba Zhen Tang For Hidden Blood Loss After Total Knee Arthroplasty Impact Analysis

ObjectivesThis study aims to use intraoperative articular Tranexamic Acid(TXA) infusion and intraoperative articular TXA infusion combined with postoperative oral Bazhen decoction treatment to Total Knee Arthroplasty (TKA) patients, respectively, to assess the impact of oral Bazhen decoction treatment on hidden Blood Loss (HBL), study its safety and provide a theoretical basis for its application in Total Knee Arthroplasty (TKA) to control postoperative hidden blood loss.MethodsThis research adopted a method of retrospective study. A total of 90 subjects were strictly selected, in accordance with inclusion and exclusion criteria, from patients undergoing Total Knee Arthroplasty (TKA)in the department of orthopedics, Guangdong Provincial Hospital Of TCM. Treated with different Hemostatic Therapy, they were categorized into three groups:group A:intraoperative articular TXA infusion,30 cases;group B:intraoperative articular TXA infusion combined with postoperative oral Bazhen decoction treatment,30 cases;group C:control group,30 cases. TKA surgery to these patients were all performed by a same surgeon and they received uniform postoperative rehabilitation and functional exercise and stayed in hospital for about 7 days before discharge. By using SPSS22.0 statistical software,results from variance test and chi-square test were compared in an scientific manner by means of one-way analysis of variance(one-way ANOVA). If the preoperative situations are comparable, further analyses will be made on whether the data, like total blood loss, dominant blood loss and hidden blood loss,postoperative volume of drainage and preoperative and postoperative hemoglobin, have statistical differences among groups. ResultsBy means of one-way analysis of variance test, comparisons are made among groups in the aspects of knees gone through TKA, medical diseases, sex, height, age, weight, BMI, preoperative hemoglobin, preoperative D-dimer, intraoperative blood loss and other baseline data, P＞0.05; preoperative HSS score, P＞0.05, Which shows balanced baseline characteristics making three groups, A B C, comparable.In terms of total blood loss,there are statistical differences among the three groups. Pairwise comparison results show that differences exist between A and B, differences exist between A and C, differences exist between B and C (P<0.05).In terms of hidden blood loss, there are statistical differences among the three groups. Pairwise comparison results show that differences exist between A and B, differences exist between B and (P＜0.05), no differences between A and C.In terms of Hemoglobin difference, there are statistical differences among the three groups. Pairwise comparison results show that differences exist between A and B, differences exist between B and C (P＜0.05), no differences between A and C (P＞0.05).In terms of postoperative volume of drainage, there are statistical differences among the three groups. Pairwise comparison results show that differences exist between A and B, differences exist between B and C (P＜ 0.05),no differences between A and B (P＞0.05).In terms of HSS, no differences among three groups (P＞0.05).In terms of dominant blood loss, there are statistical differences among the three groups. Pairwise comparison results show that differences exist between A and B, differences exist between B and C (P＜0.05), no differences between A and C (P＞0.05).In terms of hidden blood loss, there are statistical differences among the three groups. Pairwise comparison results show that differences exist between A and B, differences exist between B and C (P＜0.05), no differences between A and C (P＞0.05).ConclusionsThe research data show that intraoperative articular TXA infusion in TKA surgery will not increase the risk of deep venous thrombosis, but intraoperative articular TXA infusion combined with postoperative oral Bazhen decoction treatment can reduce postoperative D-dimer, lower risk of deep venous thrombosis, and significantly reduce postoperative hidden blood loss so that less blood volume loss. By relating to clinical data, results can be interpreted as, in the third postoperative day, hemoglobin and HCT value reached their minimum during perioperative period and exhibited a gradual and steady recovery trend later on. Therefore,the amount of red blood cells loss of patients reached its maximum in the third postoperative day and afterwards, the body itself can gradually make compensation recovery.