Clinical Study Of Electroacupuncture Combined With Continuous Femoral Nerve Block For Prevention Of Deep Venous Thrombosis After Total Knee Arthroplasty

Objective To investigate the preventive effect of electroacupuncture combined with continuous femoral nerve block on deep vein thrombosis after total knee arthroplasty.Methods Two hundred patients with knee replacement surgery were randomly divided into 4 groups,each group contained 50 patients.They were divided intravenous analgesia group(PCIA group),nerve analgesia group(PCNA group),intravenous analgesia combined with electroacupuncture treatment group(PCIA+EA group),and nerve analgesia combined with electroacupuncture group(PCNA + EA group).The incidence of postoperative deep venous thrombosis(DVT)and the changes of platelet count,D-dimer index and hemorheology index were observed.Results Compared with the PCIA group,the incidence of deep vein thrombosis was significantly lower in the PCNA group,PCIA+EA group,and PCNA+EA group(P<0.05).Compared with the PCNA group,the incidence of DVT was lower in the PCNA+EA group.The difference was statistically significant(P<0.05).Compared with PCIA+EA group,the incidence of DVT in PCNA+EA group decreased,the difference was statistically significant(P<0.05).Compared with preoperative,the platelet count of four groups increased on the first day after operation,the difference was statistically significant(P<0.05).Compared with the first day,the 7th day after surgeryof PCIA+EA group and PCNA+EA group,the platelet count decreased,the difference was statistically significant(P<0.05).Compared with the PCIA group,the platelet count of PCNA group,PCIA+EA group and PCNA+EA group decreased on the 7th day after operation,the difference was statistically significant(P< 0.05).Compared with the first day after surgery,the D-dimer index of each group increased on the 7th day after operation,the difference was statistically significant(P<0.05).Compared with the PCIA group,the PCIA+EA group on the 7th day after operation,the D-dimer index of PCNA+EA group decreased,and the difference was statistically significant(P<0.05).Compared with the first day after surgery,the whole blood viscosity of the PCIA+EA group and the PCNA+EA group decreased at the 7th day after surgery,and the erythrocyte aggregation index decreased.The difference was statistically significant(P<0.05).In the PCIA+EA group,the original and plasma viscosity decreased,but the difference was not statistically significant(P>0.05).Compared with the PCIA group,the whole blood viscosity of the PCIA+EA,PCNA+EA group was lower and the erythrocyte aggregation index was decreased on the 7th day after surgery(P<0.05).The fibrinogen and plasma viscosity of the PCIA+EA group decreased,but the difference was not statistically significant(P>0.05).Conclusion Postoperative analgesia with continuous femoral nerve block can reduce the incidence of DVT compared with traditional venous analgesia.Combined electroacupuncture treatment can further reduce the occurrence of postoperative DVT.