Clinical Study On The Prevention Of DVT After Tibial Plateau Fracture Operation By TCM Directional Drug Penetration Therapy

Objective: to study the clinical effect on the prevention of DVT after tibial plateau fracture operation by TCM directional drug penetration therapy,so as to guide clinical application.Methods: Sixty patients with tibial plateau fractures who were treated in the orthopedics department of the third affiliated hospital of yunnan university of TCM from December2018 to January 2020 and received good follow-up were selected.According to the sequence of admission to the hospital,the patients were divided into two groups,30 were in the observation group and 30 in the control group.The control group was given hypodermic injection of low molecular heparin calcium 24 h after the operation,4100 AXaIU for each time,once a day,for 14 consecutive days.On the basis of the same treatment as the control group,the observation group began to add TCM directional drug penetration Therapy 24 h after the operation,the treatment site is located inside and outside the knee and calf,the prescription was Shentong Zhuyu decotion,20 min each time,2times a day,for 14 consecutive days.Observe and record the data of two groups of cases,including preoperative 1 day,1 day after operation(before treatment),1 week,2 weeks after treatment on the four coagulation terms,D-dimer,VAS pain score,swelling value,lower limb vascular color doppler ultrasound results,by contrast to evaluate the clinical effect on the prevention of DVT after tibial plateau Fracture operation by TCM directional drug penetration therapy.Results: 1.Comparison of baseline data: there was no statistical difference in gender,age,injury side,fracture type classification,the four coagulation terms,D-dimer,VAS pain score,swelling value,lower limb vascular color doppler ultrasound results between the twogroups(P>0.05),indicating that the baseline condition between groups was the same.2.Comparison of four coagulation terms and D-dimer: comparison in the group:comparison of statistical test between 1 week,2 weeks after treatment and before treatment revealed significant difference(P<0.01).Both groups significantly increased the value of PT,APTT,TT,significantly decreased the value of FIB,D-dimer,and improved the coagulation function.comparison between groups: observation group and control group by statistical test showed that: 1 week after treatment on the PT(P<0.05)there was statistical difference,had significant difference on the APTT(P<0.01),on the TT,FIB,D-dimer(P>0.05)there was no statistical difference,the observation group was stronger than the control group in increasing the value of PT and APTT;2 weeks after treatment,the difference was significant on the PT,APTT(P<0.01),on the TT,FIB,D-dimer(P<0.05)had difference,the observation group was stronger than the control group in increasing the value of PT,APTT,TT,and stronger than the control group in decreasing the value of FIB,D-dimer.3.Comparison of VAS pain score: comparison in the group : comparison of statistical test between 1 week,2 weeks after treatment and before treatment revealed significant difference(P<0.01).Both groups significantly reduced VAS score and relieved pain of the injuerd limb.comparison between groups:observation group and control group by statistical test showed that: 1 week after treatment on the VAS pain score(P<0.05)there was statistical difference,2 weeks after treatment on the VAS pain score(P<0.01)there was significant statistical difference,the observation group was significantly stronger than the control group in the reduction of scores.After treatment,the effective rate of the observation group was 100% and that of the control group was 90%.The two groups through the statistical test(P<0.05),there was statistical difference.4.Comparison of swelling value: comparison in the group : comparison of statistical test between 1 week,2 weeks after treatment and before treatment revealed significant difference(P<0.01).Both groups can significantly reduce the swelling value and improve the degree of limb swelling.comparison between groups:observation group and control group by statistical test showed that: 1 week after treatment on the swelling value(P<0.01)there was significant statistical difference,the observation group was significantly stronger than the control group in reducing the swelling;2 weeks after treatment on the swelling value(P>0.05)there was no statistical difference.After treatment,the effective rate of the observation group was 100% and that of the control group was 90%.The two groups through the statistical test(P<0.05),there was statistical difference.5.Comparison of lower limb vascular color doppler ultrasound results:After 1 week of treatment in the two groups,the positive rate of lower limb vascular color doppler ultrasound results in the observation group was 0%,and the positive rate of lower limb vascular color doppler ultrasound results in the control group was 7%.After 2 weeks of treatment in the two groups,the positive rate of lower limb vascular color doppler ultrasound results in the observation group was 0%,and the positive rate of lower limb vascular color doppler ultrasound results in the control group was 10%.The two groups through the statistical test(P>0.05)there was no statistical difference.6.Comparison of safety index: The main indexes of blood routine,liver and kidney function before and after treatment were in the safe range in the two groups,and through the statistical test(P>0.05)there was no statistical difference.Conclusion: It has definite curative effect on the Prevention of DVT after Tibial Plateau Fracture Operation by TCM Directional Drug Penetration Therapy.It has better clinical efficacy in improving coagulation function,relieving pain and swelling of the injuerd limb.Thus,the velocity of venous blood flow can be accelerated,the hypercoagulability of blood can be improved,the clinical symptoms can be improved to promote early recovery after the operation,so as to reduce the incidence of DVT,worthy of clinical promotion.