| Objective: The purpose of this study is to discuss the different usage of Shentong Zhuyu decoction combined low molecular heparin calcium on the incidence of deep vein thrombosis after total hip replacement and the effect of play to traditional Chinese medicine in the prevention and control of deep vein thrombosis after total hip replacement effect,improve prognosis,provide the reference of drug use for total hip replacement.Method: From February 2019 to January 2020 During the month,105 patients who had undergone total hip replacement in the Airport Hospital of Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine met the inclusion criteria were divided into three groups according to the random number table: oral group,fumigation and washing group and simple heparin group.After the operation,the patients in the oral combination group were given Shentongzhuyu Decoction and hypodermic injection of low-molecular-weight heparin calcium.After the operation,the patients in the fumigation and washing group were given Shentongzhuyu Decoction and fumigation Combined with low molecular weight heparin calcium subcutaneous injection,the patients in the simple heparin group were treated with low molecular weight heparin calcium subcutaneous injection after operation,the other treatment measures were no difference,and the treatment courses of the three groups were all set as 10 days.Observe and record the D-dimer,FIB,VAS pain score,the difference between the healthy side and the thigh circumference of the affected side on the first day,the fifth day and the11 th day after the operation,count the incidence of deep vein thrombosis andother adverse reactions,follow up the patients' return to hospital one month after the operation,and then use SPSS software to analyze the statistical data to observe the curative effect No difference.Results:1.Coagulation function(D-dimer,FIB): on the 1st,5th and11 th day after operation,there was statistically significant difference in coagulation parameters among the three groups(P<0.05).On the first day after operation,there was no significant difference between the three groups(P>0.05).The difference was statistically significant(P<0.05)between the oral combined group,the fumigation washing combined group with the simple heparin group on the 5th and 11 th day after operation.There was no significant difference between the oral combined group and the fumigation washing combined group(P>0.05),indicating that the fumigation washing combined group and the oral combined group were better than the low-molecular-weight heparin calcium alone in improving the coagulation function(D-dimer,FIB).2.VAS pain score: on the 1st,5th and 11 th day after operation,there was significant difference among the three groups(P<0.05).On the first day after operation,there was no significant difference in pain score among the three groups(P>0.05).On the 5th and 11 th day after operation,there was a significant difference(P<0.05)between the oral combined group,the fumigation washing combined group with the simple heparin group.There was no significant difference(P>0.05)between the oral combined group and the fumigation washing combined group,indicating that the oral combined group and the fumigation washing combined group had more significant improvement in postoperative pain than the simple heparin group.3.Peripheral diameter difference of thigh: on the 1st,5th and 11 th day after operation,there was statistically significant difference between the threegroups(P<0.05).On the first day after operation,there was no significant difference between the three groups(P>0.05).On the 5th and 11 th day after operation,the difference of the peripheral diameter of thigh between the three groups was compared.The difference was statistically significant(P<0.05)between the oral combined group,the fumigation washing combined group and the simple heparin group.The difference was statistically significant(P<0.05)between the oral combined group and the fumigation washing combined group.The results showed that the effect of fumigation washing combined group was the best,followed by oral combined group and heparin group.4.The occurrence of deep vein thrombosis: on the 11 th day after operation,all the patients in the three groups were examined by color Doppler ultrasound in the color Doppler room of our hospital.4(11.4%)cases of deep vein thrombosis were found in heparin group,2(5.7%)cases in fumigation washing group and 1(2.9%)case in oral combination group,There was no significant difference between the three groups(P>0.05),which indicated that the three groups could effectively prevent the occurrence of DVT,but there was no significant difference between the three groups.5.Adverse reactions and complications: there was one case of wound infection in the fumigation and washing group,and there was no wound infection in the other two groups.There were no other obvious adverse reactions and complications in the three groups.6.One month return rate after operation: three groups of patients were not admitted to our orthopedic department within one month after operation.Conclusion:(1)Oral Shentongzhuyu decoction combined with low-molecular-weight heparin calcium and external Shentongzhuyu Decoction fumigating and washing combined with low-molecular-weightheparin calcium can significantly improve the D-dimer,FIB and other related coagulation indicators of patients after total hip replacement,reduce the degree of limb swelling,reduce pain,and prevent deep vein thrombosis of patients after operation.Among them,oral Shentongzhuyu decoction combined with low-molecular-weight heparin calcium is similar to external Shentongzhuyu Decoction fumigating and washing combined with low-molecular-weight heparin calcium in the improvement of blood coagulation index of postoperative patients,and similar in the improvement of postoperative pain,which are better than the treatment effect of low-molecular-weight heparin calcium alone.Among the three groups,Shentongzhuyu decoction combined with fumigation and washing group had the best effect on postoperative limb swelling,followed by Shentongzhuyu decoction oral combined group,and low molecular weight heparin calcium alone had the worst effect.(2)The short-term curative effect of the three groups of subjects was good,and there was no return to hospital within one month after the operation. |
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