三七止血汤治疗人工全髋关节置换术围手术期失血临床研究

目的:探讨围手术期应用三七止血汤减少人工全髋关节置换术失血的有效性。方法:选取行人工全髋关节置换术患者90例,按随机数字表法分为三七止血汤组、氨甲环酸组和空白对照组,每组30例。三七止血汤组术前1天和术后连续3天口服三七止血汤,氨甲环酸组术前1天和术前15 min开始静脉点滴氨甲环酸,伤口关闭时关节腔内注射60 mL,空白对照组不应用任何止血药物。比较3组患者显性失血量、隐性失血量、总失血量、需要输血患者人数、输血量、不同时间血红蛋白(Hb)的变化。结果:三七止血汤组和氨甲环酸组总失血量、显性失血量及隐性失血量均显著低于空白对照组(P<0.05)。三七止血汤组和氨甲环酸组术后输血量和输血例数均低于空白对照组(P<0.05)。术后第3天,3组Hb水平较术前2天明显下降(P<0.05)。术后第3天,三七止血汤组和氨甲环酸组Hb水平高于空白对照组(P<0.05)。结论:三七止血汤能显著减少人工全髋关节置换术的总失血量、显性失血量及隐性失血量,降低输血患者数量和输血量,能有效减少人工全髋关节置换术围手术期失血,与氨甲环酸效果相当。

Clinical Study on Sanqi Zhixue Tang for Blood Loss During Perioperative Stage of Total Hip Arthroplasty

Objective:To discuss the effect of Sanqi Zhixue Tang for the reduction of blood loss during perioperative stage of total hip arthroplasty.Methods:A total of 90 cases of patients who underwent total hip arthroplasty were selected and divided into the Sanqi Zhixue Tang group,the tranexamic acid group and the control blank group according to the random number table method,30 cases in each group.The Sanqi Zhixue Tang group was treated with oral administration of Sanqi Zhixue Tang one day before operation and three continuous days after operation;the tranexamic acid group was treated with intravenous drip of tranexamic acid one day before operation and 15 min before operation,and was intra-articularly injected with 60 ml tranexamic acid when the wound was closed;no hemostatic drugs were applied to the blank control group.The overt blood loss,hidden blood loss,total blood loss,number of patients requiring blood transfusion,blood transfusion volume and the changes of hemoglobin(Hb)at different time in the three groups were compared.Results:The total blood loss,overt blood loss and hidden blood loss in the Sanqi Zhixue Tang group and the tranexamic acid group were significantly lower than those in the control blank group(P<0.05).The blood transfusion volume and number of patients requiring blood transfusion in the Sanqi Zhixue Tang group and the tranexamic acid group were significantly lower than those in the control blank group(P<0.05).On the third day after operation,the Hb levels in the three groups were significantly decreased when compared with those two days before operation(P<0.05).On the third day after operation,the Hb levels in the Sanqi Zhixue Tang group and the tranexamic acid group were respectively higher than that in the control blank group(P<0.05).Conclusion:Sanqi Zhixue Tang can significantly reduce the total blood loss,overt blood loss,hidden blood loss,blood transfusion volume and number of patients requiring blood transfusion during total hip arthroplasty.In a word,it can effectively reduce blood loss during perioperative stage of total hip arthroplasty,which has similar effect with tranexamic acid.