Clinical Study Of Tongjing Powder Acupoint Application On The Prevention Of Venous Thromboembolism After Major Orthopedic Surgery

Objective: By observing the clinical effect of Tongjing powder acupoint application on the prevention of venous thromboembolism(VTE)in patients after major orthopedic surgery,the mechanism of TCM external treatment for the prevention of VTE under the thought of preventive treatment of disease was discussed.Methods: A total of 200 orthopedic patients who met the standard for major surgery were selected and randomly divided into experimental group and control group with 100 cases each.According to the results of VTE risk assessment,the two groups of patients selected the appropriate prevention scheme(basic prevention,physical prevention,drug prevention),and the experimental group was additionally applied Tongjing powder acupoint application on this basis.The absolute value of neutrophils(ANC),Absolute value of lymphocyte(ALC),platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),fibrinogen(FIB),D-dimer,calculation of neutrophils lymphocyte ratio(NLR),platelet lymphocyte ratio(PLR)on the 1d before surgery and the7 d and 14 d after surgery in 2 groups were observed.The incidence of DVT and PE in 2groups was collected and recorded on the 1d before surgery and the 14 d and 45 d after surgery,and the clinical data of patients with VTE complicated by major orthopedic surgery were analyzed.Results: 1.Compared with 1 day before surgery,the levels of ANC,PLT,NLR,PLR,FIB and D-dimer in 2 groups were increased,while the levels of ALC and PDW were decreased 7 days after surgery.The level of MPV in experimental group was decreased(P<0.05,P<0.01).2.Compared with 1 day before surgery,the levels of ANC,ALC,MPV,PDW,NLR,FIB and D-dimer in 2 groups were decreased,while the levels of PLT and PLR were increased 14 days after surgery(P<0.05,P<0.01).3.Compared with 7 days after surgery,the levels of ANC,PDW,NLR,FIB and D-dimer in 2 groups decreased 14 days after surgery;At 14 days after operation,ALC level increased(P<0.01),while PLT,MPV and PLR levels decreased(P<0.05,P<0.01).4.Compared with the control group,FIB in experimental group decreased 7 days after surgery(P<0.05),and the levels of MPV and D-dimer decreased 14 days after surgery(P<0.05).5.There were 3 cases of DVT in experimental group and 10 cases of DVT in control group(P<0.05).There was no occurrence of symptomatic PE in both groups.6.The onset time of DVT in the test group was within 45 days after surgery,the site of the disease was the left lower limb,and the type of the disease was peripheral.In the control group,3 patients developed DVT14 days after surgery,and 7 patients developed DVT45 days after surgery.There were 5 cases of left lower limb,4 cases of right lower limb and 1 case of bilateral lower limb.There were 8cases of peripheral type and 2 cases of mixed type.Conclusion: Tongjing powder acupoint application can reduce the incidence of VTE after major orthopedic surgery by improving the hypercoagulability of blood in patients undergoing major orthopedic surgery.