Effect Of Aspirin For Prevention Venous Thromboembolism After Lower Limb Joint Replacement:A Meta-analysis

Objective Through a meta-analysis of the efficacy of aspirin in preventing VTE after lower extremity joint replacement to provide evidence for evidence-based evaluation.Methods Retrieve PubMed,CNKI,VIP and WANGFANG databases to collect all randomized controlled studies(RCT)on aspirin prevention of VTE after lower extremity joint replacement.After two person independent and strictly according to the inclusion and exclusion criteria to screening,data extraction and evaluation of the quality of included literature,meta analysis was conducted by RevMan5.3.Results Nine RCTS and 1532 subjects were eventually included.The results of meta-analysis showed that compared with the low-molecularweight heparin group,there were no significant differences between the two groups in the incidence of DVT[RR=1.17 95%CI(0.77,1.79),P=0.46],PE incidence [RR=1.36 95%CI(0.08,22.2)],hemoglobin decrease [MD=-5.45 95%CI(-14.90,3.99),P=0.26] and incisional complication incidence[RR=0.76 95%CI(0.28,2.06),P=0.59].Compared with the oral anticoagulant group,there was no significant difference between the two groups in the incidence of DVT[RR=2.17 95%CI(0.42,11.15),P=0.35] and the incidence of incision complications [RR=0.37 95%CI(0.07,1.87),P=0.23].Compared with the blank control group,aspirin reduced the incidence of postoperative DVT [RR=0.44,95%CI(0.29,0.66),P<0.0001].Conclusion The analysis result shows that :compared with low molecular weight heparin and oral anticoagulants,there were no significant differences in the incidence of DVT,PE,hemoglobin decrease and the incidence of incision complications.Compared with the control group,aspirin reduced the incidence of DVT after lower limb joint replacement.Therefore,aspirin is equivalent to LMWH and oral anticoagulant,and can be used for the prevention of venous thromboembolism after lower extremity joint replacement.Background With the rapid development of medical technology,the safety and effectiveness of anesthesia have been paid more and more attention by scholars.The choice of brachial plexus nerve block in upper extremity surgery is still a hot topic.Brachial plexus block with different approaches can be selected in the operation of different regions of upper limbs,and how to regulate brachial plexus block still needs further consideration and discussion by clinical scholars.Objective Through exploring the commonly used methods and application progress of brachial plexus nerve block such as muscle sulcus,supraclavicular,infraclavicular and axillary road brachial plexus nerve block,the selection of brachial plexus nerve block anesthesia method is more definite and organized.So as to make brachial plexus nerve anesthesia more safe and effective and more widely used in clinic.Content This article reviews the application of brachial plexus block.