Clinical Observation Of Shentong Zhuyu Decoction In Preventing Deep Venous Thrombosis After Single Knee Arthroplasty In Knee Joint

Objective:To observe the effect of Shentong Zhuyu Decoction on the platelet count,fibrin degradation product,D-dimer and other coagulation and fibrinolysis indicators in patients after unicompartmental knee arthroplasty,to explore the prevention of knee pain with Tongtong Zhuyu Decoction The clinical efficacy,safety and possible mechanism of the deep venous thrombosis after unicompartmental knee arthroplasty.Methods:A total of 43 patients with medial compartment osteoarthritis who had undergone knee joint replacement surgery in our Department of Orthopaedics between October 2016 and March 2018 were selected.The patients had improved blood routine before operation,and had complete blood coagulation and many lower limb blood vessels.Puller color ultrasound examination to understand the lower limb venous valve function and coagulation.All operations were performed by a doctor in the same surgery group,using epidural anesthesia,minimally invasive paramedial approach,and tourniquets were used throughout.The time was <90 minutes.Postoperative elastic bandage bandages,raising the affected limbs,conducting thromboprophylaxis knowledge education,and early exercise of limb paralysis pump function.Forty-three patients were randomly divided into observation group(22 cases)and control group(21cases).The observation group was given oral Tongxue Zhuyu Decoction(250ml)+Rivaroxaban(10mg)for 2 weeks on the first postoperative day,and the control group was treated for 2 weeks.After 12 hours,oral rivaroxaban 10 mg was started once a day for 2 weeks.Two groups of patients underwent whole blood coagulation and blood routine examination on the 1st day before operation and on the 1st,1st,and 2nd week after operation.The drainage volume was recorded.When the drainage volume was<50ml for 24 hours after continuous operation,the drainage tube was pulled out;After one week and two weeks,the lower extremity Doppler color ultrasound was used to detect the formation of deep venous thrombosis of the lower extremities.Finally,the results of platelet counts,fibrin degradation products,and D-dimer coagulation indexes were statistically analyzed in both groups.Results:1.The preoperative random factors(gender,age,height,weight,coagulation index)were not significantly different between the observation group and the control group(P>0.05);2.The levels of platelet,D-dimer,and fibrin degradation products increased significantly on the first day after operation in both groups.The thrombin time,prothrombin time,and activated partial thromboplastin time were significantly shorter than those before surgery.The difference was statistically significant(P<0.01 or P<0.05),which confirmed the conclusion that blood was hypercoagulated after UKA;3.Intra-group comparison The thrombin time blood parameters were prolonged at1 week after surgery in both groups,and the platelet count,fibrin degradation products,and D-dimer levels decreased(P<0.01 or P<0.01).0.05);between groups,thrombin time,prothrombin time,activated partial thromboplastin time had no significant difference between the two groups(P> 0.05),fibrin degradation products,D-dimer levels have significant differences(P<0.01),confirmed that the observation group can effectively inhibit fibrinolysis at the same time as anticoagulation;4.At 2 weeks after operation,platelet count,D-dimer,fibrin degradation products,and various coagulation time levels were not significantly different(P>0.05);5.Between groups,there was no significant difference in drainage volume between the two groups at 24 h(P>0.05).There was a statistically significant difference in total drainage volume at 48 h postoperatively(P<0.01),indicating that the combination of Chinese and Western medicine is While enhancing anticoagulant efficacy,it does not increase the risk of bleeding;6.There was no statistical difference in the incidence of DVT between the two groups.Conclusion: Shentong Zhuyu Decoction has good anticoagulant effect,does not increase the risk of bleeding while anticoagulation,can significantly improve the blood hypercoagulability state after UKA,effectively reduce the incidence of DVT after UKA,and Shentong Zhuyu Decoction no Obvious adverse reactions,cost-effectiveness,safety,effectiveness,and ease of use are worth promoting in clinical practice.