| Objective: Objective To observe the occurrence of early lower extremity deep venous thrombosis(DVT)in patients after primary total hip arthroplasty(THA)by oral administration of Buyang Huanwu Decoction(BYHWD),and to explore the clinical effect value of accelerating rehabilitation perioperative application of BYHWD in the prevention of DVT.Methods:From June 2020 to February 2021,the patients who met the inclusion criteria and exclusion criteria were randomly divided into control group and experimental group,50 cases in each group.Both groups were treated with the concept of rapid rehabilitation to prevent thrombosis.The control group was given subcutaneous injection of low molecular weight heparin calcium(4100 IU,QD,time 1 week)combined with pneumatic therapy(limb compression system)Dvt-2600,twice a day,30 minutes each time,for 1 week)to prevent deep venous thrombosis of lower limbs.Oral administration of aspirin(0.1g,once a day,for 4weeks)was started in the second week after operation.Patients with postoperative venous thrombosis of lower limbs without interventional surgery were given subcutaneous injection of low molecular weight heparin calcium(4100iu,q12 h,for 1 week),and oral administration of rivaroxaban(15mg,twice a day,for 1 week)4 weeks).On the basis of the control group,the experimental group took Buyang Huanwu Decoction orally on the first day after operation,one dose a day for 2 weeks.Before operation,1 day after operation,3,5,14 days after operation were collected Before operation,1 day after operation,3,7,14 days after operation,the R value,a value,Ma amplitude,angle and other indicators in the thromboelastogram of the two groups;before operation,1 week after operation,2 weeks after operation,the color Doppler ultrasound of the affected lower extremity arteries and veins of the two groups were examined,the incidence of postoperative thrombosis and the blood flow velocity of the common femoral vein before and after operation were compared;the total blood loss and postoperative invisible blood loss of the two groups were calculated Blood volume.Spss20 statistical software was used to analyze the data and compare the clinical efficacy between the two groups.Results:In this study,89 cases were followed up,44 in the experimental group and 45 in the control group.1.General data: there was no statistical difference between the two groups in sex,age,surgical site and operation time,and it was comparable.2.Hemoglobin: hemoglobin in the two groups decreased from the first day after operation,and gradually recovered on the 5th day after operation.However,there was no significant difference in hemoglobin in the two groups before and after operation,and there was no statistical significance.3.Blood loss: the results showed that there was no significant difference between the two groups.4.Thromboelastic chart: the R value of the two groups increased slightly on the first day after operation,decreased to the lowest value on the third day,and slightly increased on the7 th day;the K value decreased continuously from the first day after operation;the amplitude of angle and Ma decreased slightly on the first day after operation,and increased after the third day.All the indexes were gradually recovered to the preoperative level at 14 days after operation.The difference of R,K,Ma amplitude and angle of thrombus elasticity was statistically significant in the three and seven days after operation in the two groups,and there was no significant difference in the indexes of the thrombus elasticity between the two groups in the rest of the time.The difference of R,K,angle and Ma amplitude of each time point in the control group was statistically significant.There was no significant difference in R and K values in each time point in the experimental group,and there was no statistical significance after comparison.The difference of Ma amplitude and angle in each time point in the experimental group was statistically significant.5.The occurrence of venous thrombosis of lower extremity: no thrombosis was found in both groups before operation.On the first day after operation,2 patients in the control group found deep vein thrombosis of lower extremity,and 1 case in the experimental group found deep vein thrombosis of lower extremity.The results showed that there was no significant difference between the control group and the experimental group.On the first day after operation,14 patients in the control group found the lower extremity intermuscular vein thrombosis,and 5 patients in the experimental group found the lower extremity intermuscular vein thrombosis.The results showed that the incidence of intramuscular vein thrombosis in the control group was significantly higher than that in the experimental group.6.The velocity of the total femoral vein: on the first day after operation,there was no significant difference in the velocity of the total femoral vein in the two groups;at the first week after the operation,the velocity of the total femoral vein in the experimental group was significantly faster than that of the control group;at the second week after the operation,there was no significant difference in the velocity of the total femoral vein between the two groups.7.TCM syndrome efficacy: there was no significant difference in TCM syndrome score between the control group and the experimental group before treatment,but the total effective rate of TCM in the experimental group was significantly higher than that in the control group after treatment,with statistical significance.Conclusion:Buyang Huanwu Decoction can reduce the hypercoagulable state 3-7 days after THR,improve the blood flow velocity of lower extremity vein 1 week after THR,effectively prevent deep venous thrombosis of lower extremity after THR,and reduce the incidence of intramuscular venous thrombosis of lower extremity;And the application of Buyang Huanwu Decoction will not cause the increase of postoperative blood loss and hidden blood loss,with high safety. |
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