Clinical Efficacy Of Fuyuan Huoxue Decoction Combined With Rivaroxaban For Preventing Postoperative Thrombosis Of Patella Fractures In Elderly Patients

Objective: To compare the efficacy of Fuyuan Huoxue Decoction combined with rivaroxaban and rivaroxaban alone in preventing thrombosis in elderly patients after patellar fracture surgery.To provide a more safe and effective treatment idea and method for the prevention of thrombosis after clinical lower extremity fracture surgery,and at the same time to promote the sharing of relevant treatment experience.Methods: A total of 60 elderly patients who underwent surgery for patellar fractures in the Department of trauma orthopedics,Affiliated Hospital of Shandong University of Chinese medicine,from January 2019 to September 2020 were selected for the study,and the subjects were divided into experimental and control groups according to the random number table method,and both patients were given anticoagulation with conventional rivaroxaban tablets,in which the Fuyuan Huoxue Xue Decoction was applied on the basis of basic treatment in the experimental group.D-dimer value on admission,activated partial thromboplastin time(APTT),plasma prothrombin time(PT),and fibrinogen value(FIB)were compared between the two groups,and blood samples were collected in a fasting state in the early morning,on the 1st,7th,and14 th postoperative days,respectively.Changes in postoperative visual analog scale,changes in the circumferential diameter of the lower leg after surgery,changes in TCM syndrome scores before and after treatment,and the incidence of adverse events were compared between the two groups.Double lower limb deep vein color ultrasound was reviewed on the 14 th postoperative day,and it was clear whether there was thrombosis.All data were processed with SPSS 26.0.Result: 1.The two groups were compared in terms of age,gender,BMI,surgical site,delayed operation time,and operative time,which were not significantly different,all P>0.05,confirmed comparability between the two groups.2.D-dimer: there was no significant difference in D-dimer values between the two groups of patients before and on postoperative day 1,P> 0.05,and the experimental group showed significantly smaller values than the control group on both postoperative day 7 and 14,P<0.05.3.APTT and PT: there were no significant differences in APTT values between the two groups of patients before,on the 1st and 7th postoperative days,P>0.05.Values in the experimental group were significantly greater than those in the control group on the 14 th postoperative day(P<0.05).4.FIB: there were no significant differences in FIB values between the two groups on the preoperative and postoperative day 1,P>0.05,and the experimental group had significantly smaller FIB values than the control group on both the 7th and 14 th postoperative day,P<0.05.5.vas score: there was no significant difference in VAS score between the two groups on postoperative day 1,P>0.05.The experimental group had significantly smaller values than the control group on both the 7th and 14 th postoperative days,P<0.05.6.Calf circumference:there was no significant difference in calf circumference between the two groups on postoperative days 1 and 7,P > 0.05.All values in the experimental group were significantly smaller than those in the control group on the 14 th postoperative day(P < 0.05).7.DVT incidence: the incidence of DVT was 0%(0cases)in the experimental group and 7.14%(2 cases)in the control group,P>0.05,which was not significantly different between the two groups and not statistically significant.8.Adverse events: the incidence of DVT was 10.71%(3 patients)in the experimental group and 7.14%(2 patients)in the control group,P>0.05,which was not significantly different between the two groups and not statistically significant.9.There was no significant difference in TCM syndrome scores between the two groups before treatment,P>0.05.Treatment was significantly lower in the experimental group than in the control group at P<0.05.In terms of efficacy,the experimental group could significantly improve the efficacy of TCM syndromes compared with the control group with P<0.05.Conclusion:Fuyuan Huoxue Decoction combined with rivaroxaban can effectively improve blood indicators,reduce the hypercoagulable state of blood,and reduce the incidence of DVT in elderly patients after patellar fracture surgery.At the same time,being able to reduce pain,relieve swelling of the affected limb as well as improve TCM syndrome scores,and did not induce the occurrence of serious adverse events.