| Objective: This clinical trial aims at preventing of the deep venous thrombosis(DVT)of lower extremity after the operation of total hip arthroplasty(THA).GuiPi Decotion combined with Rivaroxaban and just Rivaroxaban only are used as different treatment methods to treat the patients who are suffered the operation of THA.Then study and evaluate the effect of the anticoagulant,the amount of bleeding after the operation,and safety of the two kinds of treatment measures.As a result of providing the theoretical basis and reference about how does the GuiPi Decotion reduce the risk of bleeding after the THA operation caused by Rivaroxaban which is used to prevent the DVT.Methods: The study objects are all patients chose from the Joint Department in He Nan hospital of TCM,who are suffered the operation of unilateral total hip replacement,time ranges from September,2014 to September,2016.According to the inclusion and exclusion criteria strictly,90 cases are enough.Randomly divided them into two groups as test group and control group,45 cases in each group,all suffered combined spinal-epidural anesthesia,and the operation are all completed by the same group of surgeons and the same group of anesthesiologists.Let them do the unified rehabilitation exercise.About 14 days later they can get out of the hospital.Patients in the test group were orally given 10 mg Rivaroxaban 8h later of the operation,once a day,and last 14 days;the control group are treated as the test group while combined with GuiPi Decoction,once a day,drink it in the morning and evening,also for 14 days.Before and after surgery and given medicine,the index of the two groups of prothrombin time(PT),activated partial thromboplastin time(APPT),fibrinogen(FIB),two D-dimer(D-dimer),hematocrit(HCT),hemoglobin(HB)were observed and recorded.The total blood loss,blood loss,the hidden blood loss was dominant postoperative drainage,lower limb venous ultrasonography in detecting the incidence of postoperative DVT,were also recorded.Observed two groups of patients with subcutaneous ecchymosis appears and thigh circumference change.The clinical data were analyzed by Statistical software SPSS20.0.Results: The index as age,sex,body weight,ect,of the two groups are comparable,P>0.05;Only 5 cases in 90 patients after the operation suffered DVT,the total incidence rate was 5.55%;2 cases in test group(4.44%)and 3 cases in control group(6.66%),There is no significant difference in DVT incidence rate(P>0.05)of the two groups.Laboratory index of two groups: after first days of PT,the APTT time is shorter,FIB,two D-dimer levels,HB and HCT decreased after treatment at different time points were improved compared with that before treatment,the difference was statistically significant(P<0.05);the comparison between the two groups,experimental group in extension PT,APTT time and reduce two D-dimer levels than the control group(P<0.05).Blood loss index of the two groups: The difference was statistically significant in total blood loss and hidden blood loss,postoperative drainage,(P<0.05);clinical observation: There was statistical significance(P<0.05)about the test group had postoperative subcutaneous ecchymosis relative to the control group.Between the groups the postoperative thigh circumference increased compared with the preoperative,postoperative 7 days,the test group was significantly better than the control group(P<0.05).Conclusion:From the data in the study which observed,we can see that Give patients GuiPi Decoction combined with Rivaroxaban after the THA can not only effectively prevent the occurrence of DVT after the operation,but also can reduce the risk of DVT,and bleeding after operation,the loss of blood volume correction of anemia,the decrease in the subcutaneous ecchymosis appear and improve limb swelling has obvious advantages,compared with used Rivaroxaban only. |
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