Clinical Study Of Yiqi Huoxue Paste Combined With Low Molecular Weight Heparin Calcium To Prevent DVT After THA In Elderly Patients With Femoral Neck Fracture

Objective:This topic takes the elderly patients with femoral neck fracture as the research object,through observing the preventive effect of Yiqi Huoxue Paste with low molecular weight heparin calcium on deep venous thrombosis(DVT)after total hip arthroplasty(THA),in order to explore its effectiveness and safety,and provide reference and theoretical basis for the clinical application of integrated traditional Chinese and Western medicine to prevent DVT after THA in elderly patients with femoral neck fracture.Methods:According to the inclusion and exclusion criteria,From June 2019 to December 2020,60 elderly patients with femoral neck fracture planned to undergo total hip arthroplasty who were admitted to the Department of Traumatology and Orthopedics,Ruikang Hospital,Guangxi University of Traditional Chinese Medicine,were randomly selected.Use random number table method to divide into control group and observation group,each group has 30 cases.The control group is given subcutaneous injection of low molecular weight heparin calcium at 12 hours after operation.The observation group starts to take Yiqi Huoxue Paste on the first day after operation on the basis of the control group.The course of treatment is 14 days.Through comparative analysis of the coagulation indexes(D-dimer,PT,APTT)and hemorheology indexes(high-cut whole blood viscosity,low-cut whole blood viscosity,Plasma viscosity),hemoglobin concentration(HGB),platelets(PLT),DVT incidence,postoperative drainage,VAS score,Harris score and other indicators,to evaluate the clinical efficacy and safety of Yiqi Huoxue ointment combined with low-molecular-weight heparin calcium in preventing DVT after THA in elderly patients with femoral neck fractures.Results:There was no statistically significant difference between the baseline data of the two groups of patients(P>0.05),and the groups were comparable.On the first postoperative day,the coagulation indexes and hemorheology indexes of the two groups were compared with those in the preoperative group.D-dimer,whole blood viscosity high cut,whole blood low cut and plasma viscosity were higher than before operation.PT was lower than before operation,and the difference was statistically significant(P<0.05).On the 7th and 14 th day after operation,the coagulation indexes and hemorheological indexes of the two groups of patients were improved compared with the first day after operation,and there were differences Statistically significant(P<0.05).Comparing the coagulation indexes and hemorheology indexes of the two groups of patients on the 7th and 14 th day after the operation,the improvement of each index in the observation group was more significant than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in HGB between the two groups of patients before and on the first day after surgery(P>0.05).On the 7th and 14 th days after surgery,the HGB of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in PLT between the two groups of patients before and on the 1st and 7th day after operation(P>0.05).On the 14 th day after operation,the PLT of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).On the 14 th day after surgery,a total of 4 cases of Asymptomatic calf intramuscular venous thrombosis were found by color doppler ultrasound of lower extremity blood vessel,including 1 case in the observation group and3 cases in the control group,the incidence rates were 3.33% and 10%,and there was no statistically significant difference between the two groups(P>0.05).The postoperative drainage volume of the observation group was lower than that of the control group,but the difference between the two groups was not statistically significant(P>0.05).There was no statistically significant difference in the preoperative VAS scores between the two groups of patients(P>0.05).The comparison of the VAS scores on the 7th and 14 th day after the operation showed that the observation group was significantly lower than the control group,and the difference was statistically significant(P< 0.05).Comparing Harris scores on the 14 th day after surgery,the observation group was better than the control group,and the difference was statistically significant(P<0.05).Repeated analysis of variance showed that there was an interaction between time and intervention measures on D-dimer,PT,whole blood viscosity high cut,whole blood low cut,plasma viscosity,HGB,VAS score and other indicators(P<0.05).And the main effect was significant(P<0.05).During the research period,there were no adverse reactions and serious complications in the two groups.Conclusion:Yiqi Huoxue Paste combined with low molecular weight heparin calcium can effectively improve the coagulation index and hemorheology index of elderly patients with femoral neck fracture after total hip arthroplasty,inhibit the formation and adhesion of platelets,alleviate the hypercoagulability and high viscosity state of postoperative blood,reduce the incidence of lower extremity deep vein thrombosis,and can play the effects of replenishing qi and blood,removing blood stasis and relieving pain,It can better restore postoperative hemoglobin concentration,correct anemia,reduce pain,and accelerate postoperative recovery.Its effectiveness And the safety is better than the simple application of low-molecular-weight heparin calcium,which is worthy of clinical application.