Effects Of Jiawei Guyi Fang On Prevention Of Deep Venous Thrombosis Following Total Hip Arthroplasty

Object:Total hip arthroplasty is an operation with a high risk for deep venous thromboembolism and the prophylaxis of DVT is very significant.In our randomized study,total 114 postoperative patients are divided into three groups.To analyse the effect on prophylaxis of DVT,we take some kinds of examinations,such as the color dopler ultrasonography for patients' veins of lower extremities and data of cases' plasma D-dimer.Then we collect all data of three groups in order to calculate the incidence of DVT and observe the change of patients' plasma D-dimer.We keep an eye on the volume of wound drainage and errhysis of wound in the fourth day after the operation.By comparison,we are able to evaluate the effect and the safety of TCM treatment for prevention from DVT,and obtain the clinical evidence according to the study.Methods:By way of reviewing a great deal of literatures in Western Medicine and Chinese Medicine,we summarize and evaluate the latest advancement of DVT,including the pathological mechanism,the relative factors,the measurement and the prophylaxis.From July,2007 to January,2008,total 114 postoperative patients are divided into three groups which is based on the orders of their operations,that is so-called the TCM group,the LMWH group and the control group.According to the results of the examinations,we can assess three different treatments appropriately.Results:Postoperative patients are in higher risk of DVT,because of the hypercoagulability of blood,less mobilization and blood stasis.Our body can reduce hypercoagulability and accelerate the circulation gradually,so the concentration of plasma d-dimer are less than before and the risk of DVT are lower.Parameters among the three groups are compared as follows:(1)Incidence of DVT:control group＞TCM group,control group＞LMWH group(p＜0.05 for all);(2)Medical safety:patients remain errhysis of wound in the fourth day after the operation,LMWH group＞control group＞TCM group(p＜0.01);the volume of wound drainage:TCM group＜LMWH group(p＜0.05),control group＜LMWH group(p＜0.05).(3)Plasma d-dimer concentration:in the forth day after operation,TCM group＜control group,LMWH group＜control group(p＜0.01 for all);in the seventh day after operation,TCM group＜control group(p＜0.05),LMWH group＜control group(p＜0.01).Conclusion:By comparison,the morbidity of control group is 5.26% (2/38),none of them have obvious signs,however no patient of other two groups with DVT.From our observation,patients overtake TCM treatment or LMWH prophylaxis with basic treatment,including elastic stockings after operation, intermittent pneumatic compression,heat therapy and early mobilization,are in lower risk of DVT than those who overtake basic treatment only. Actually,multimodel prophylaxis are more effective,but the use of LMWH increase the risk of Hemorrhage.In our clinical study,we find that Jiawei Guyi Fang can balance anticoagulation and fibrinolysis,expand the vessels, resist the aggregation of platelet,accelerate the circulation gradually.The other hand,Jiawei Guyi Fang is more safe than LMWH.It can be use as a part of prophylaxis.