Clinical Study Of Xuesaitong Injection On Prevention DVT Formation After Lumbar Surgery

Objective:According to the tutor's rich clinical experience in spinal surgery and the TCM theory,based on promoting the blood circulation to remove stasis,observe the effect of traditional Chinese medicine preparation of Xuesaitong Injection on blood coagulation indexes of patients after lumbar surgery and preventive effects on postoperative formation of lower extremity deep venous thrombosis(DVT),and investigate the natural incidence of postoperative DVT formation,so as to provide a safe,effective prophylaxis for postoperative lower extremity deep vein thrombosis(DVT)for the patients undergoing spinal surgery.Methods:Based on the clinical research methodology,60 eligible in-patients undergoing lumbar spinal surgery(internal fixation)from June 2016 to March 2017 in No.1 Orthopedics Department(spine surgery),Guangzhou University of Traditional Chinese Medicine affiliated Xinhui Chinese Medicine Hospital,were selected.All the operations were performed by the same group of doctors and were numbered and grouped according to the order of surgery.The patients were randomly divided into the treatment group and the control group with 35 cases in each group.The treatment group:Xuesaitong injection(lyophilized Xuesaitong powder for injection,produced by Kunming Pharmaceutical Corp.0.4g/vial,GYZZ Z20026438)was given Day 1 morning after the surgery,400mg 5%GS 250ml,i.d,qd,for 2 consecutive weeks.Control group:from Day 1 morning,intravenous drip of 5%GS 250ml was given to the patients(qd)for 2 consecutive weeks.The patients in both groups received routine blood test and common coagulation examination before surgery and at 7d and 14d after surgery respectively.Haemoglobin(HGB,from In the results of routine blood test),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and D-dimer(D-D)(these parameters were from the common coagulation examination)were compared between both groups.Before and after the surgery,the patients in both groups also undertook both lower extremities color Doppler ultrasound examinations to determine the formation of deep venous thrombosis of lower extremities.Results:The results show that at 7d after the treatment,hemoglobin(HGB)was lower than that before surgery in the patients of both groups,however the serum prothrombin time(PT)and activated partial thromboplastin time(APTT)in the normal range,indicating no statistically significant difference between before and after treatment,and no statistically significant differences between both groups;In the treatment group,thrombin time(TT)and fibrinogen(FIB)were in the normal range,two D-dimer(D-D)was slightly higher than the normal vale;in the control group,thrombin time(TT),fibrinogen(FIB)and D-two dimer(D-D)were higher than the normal values.The difference between before and after treatment was statistically significant,and,the differences between the groups were also statistically significant.At 14d after treatment,HGB,serum PT,APTT and TT recovered to normal level in the patients in both two groups,and there was no significant difference between before and after treatment,no significant difference between both groups;D-D and FIB decreased to normal range in the treatment group,and D-D and FIB were higher than the normal level in the control group,there was significant difference before and after treatment,and the difference between the groups was statistically significant;and the treatment group was superior to the control group in terms of reducing subcutaneous bleeding of incision and deswelling.The incidence of formation of lower extremity deep venous thrombosis(DVT)after surgery in the treatment group was lower than that in the control group.Conelusion:1.in the prevention of DVT formation after lumbar surgery,Chinese patent medicine of Xuesaitong Injection(panax notoginseng saponins)may obtain satisfactory clinical efficacy,and will not cause bleeding,with good safety.2.Xuesaitong Injection has good curative effect in terms of reducing subcutaneous bleeding of incision and deswelling.3.In this study,D-dimer levels were higher than normal range at 7 d after surgery in the patients of both groups,and D-dimer level was higher than normal range at 14d after surgery in the patients of the control group,sugesting suggesting the presence of DVT risk,therefore,it is necessary for patients with DVT risk factors to take relevant preventive measures.4.without taking any preventive measures,natural incidence of DVT after lumbar surgery is low,therefore those patients with DVT-free symptoms and the absence of DVT risk factors do not need undertake routine double lower limbs venous color ultrasonography,or angiography or conventional anticoagulation treatment.