Clinical Study On The Treatment Of Hidden Blood Loss After Total Knee Arthroplasty With Quyu Tongluo Formula

Research methods: 80 patients underwent total knee arthroplasty from November2021 to November 2022 in Affiliated Hospital of Shandong Traditional Chinese Medicine University were enrolled.They were randomly divided into control group and observation group,each group included 40 participants.Tranexamic acid 0.5g(Shanghai Hyundai Hasen pharmaceutical Co,Ltd 5ml:0.25g)was given intravenously half an hour before joint replacement in the control group;40ml tranexamic acid diluent with normal salin was injected into the joint cavity after closing surgical incisions.Observation group: In addition to the above operations,the decoction of Quyu Tongluo Decoction was given from the first day after the operation for one week.Check the venous blood taken before the operation and on the 1st/3rd/5th/7th day after the operation,the hemoglobin(HGB)and hematocrit(HCT)values were also compared respectively.Record the intraoperative bleeding volume,postoperative blood transfusion volume,intraoperative and postoperative drainage volume and postoperative incision exudation volume of each patient,and calculated the hidden blood loss volume of the patient according to the recorded data reference formula;The limb circumference 15 cm above and 10 cm below the patella was respectivly measured before operation and on the 1st/3rd/5th/7th day after operation;Visual analog scale was used to record the VAS value before and on the 1st/3rd/5th/7th day of operation;HSS(hospital for special surgery,HSS)score was selected and recorded before and on the 1/2/3weeks after operation.Results: There were 38 patients in the control group and 36 patients in the observation group.1.General information: There were no dramatic discrepancy in the gender,age,weight,height(P>0.05).2.Preoperative examination data: preoperative HGB,preoperative HCT,preoperative VAS and preoperative HSS data were tested by two independent sample rank sum test,and there were no dramatic discrepancy in these indexs(P>0.05).3.Blood loss: The intraoperative blood loss was significantly different(P<0.05),while the postoperative blood loss were not significantly different(P>0.05);But there was no dramatic discrepancy in the total dominant blood loss(P>0.05);Two independent sample t-tests were performed on the data of occult blood loss of patients in the two groups,and there was dramatic discrepancy between the two groups(P<0.05).4.Comparison of postoperative indicators: The HGB of the two groups were significantly different(P<0.05);The comparison of HCT of postoperate showed a dramatic discrepancy between the two groups(P<0.05).5.Comparison of postoperative VAS and HSS: The VAS data of two groups of patients were tested by two independent samples,and there was no dramatic discrepancy between the two groups(P>0.05);The HSS of postoperate of the two groups showed a dramatic discrepancy(P<0.05).6.Comparison of limb circumference and swelling value: The limb circumference15 cm above the patella before operation and limb swelling value after operation in the two groups were compared,and there was a dramatic discrepancy between the two groups(P>0.05);There was no dramatic discrepancy between the two groups on the limb swelling value on the first day after operation(P>0.05),but there was dramatic discrepancy between the two groups on the 3rd/5th/7th day after operation(P<0.05).Conclusion: Quyu Tongluo Formula can reduce the amount of occult blood loss after TKA,reduce the total amount of blood loss after TKA,improve the swelling of knee joint after TKA,relieve the postoperative pain and play a positive role in restoring the normal function of knee joint.