Evaluation Of The Short-term Effect Of Guideline-based Anticoagulant Optimization After Total Knee Arthroplasty

Objective: In this study,by observing the incidence of lower extremity deep vein thrombosis in TKA patients after operation based on the Chinese Guidelines for the Prevention of VTE in Major Orthopedics Surgery,the prevention effect of lower extremity venous thrombosis in TKA patients after operation under the guidance of existing anticoagulation guidelines was evaluated,so as to provide reference for the prevention of venous thrombosis after TKA.By combining with Huoxue Tongmai tablet,the clinical effect of combined traditional Chinese and western medicine in preventing lower extremity venous thrombosis after TKA was observed and the mechanism of action was discussed.Methods: According to inclusion criteria,From December 2019 to February2021,60 patients were selected for the first unilateral total knee arthroplasty in orthopedic department of Shandong traditional Chinese Medicine Hospital due to simple knee osteoarthritis,It was divided into observation group and control group according to the principle of random control,30 cases per group,All patients were treated with the guidelines for the prevention of venous thromboembolism in major orthopedic surgery,Among them,the observation group,on the basis of routine treatment,from the first day after operation,was given oral Huoxue Tongmai tablet(10 tablets tid),Take the medicine until 35 days after operation.Both groups of patients were performed on 35 days after the operation of bilateral lower extremity venous color ultrasound examination to determine the occurrence of lower extremity dvt;Blood plasma d-dimer was detected before and after operation on 7 and 35 days;On the 1st,7th and 35 th days after operation,the circumference of both sides was measured and the circumference difference was calculated;vas pain score and knee hss score were performed preoperatively and postoperatively on days 7 and 35.Finally use spss19.0 to carry on the statistical analysis to the above data.Results:1.On the 35 th day after operation,there was no significant difference in dvt between the two groups(p>0.05).2.There was no significant difference in preoperative d-dimer between the two groups(p>0.05);on the 7th day after operation,there was significant difference between the two groups(p<0.05);on the 35 th day after operation,there was no significant difference between the two groups(p>0.05).3.On the first day after operation,the circumference difference between bilateral thigh and bilateral leg was measured(15 cm above patella and10 cm below patella).There was no significant difference between the two groups(p>0.05);but the above data on the 7th day and 35 th day after operation were significantly different between the two groups(p<0.05).4.There was no significant difference in vas score between the two groups before operation(p>0.05);on the 7th day after operation,there was significant difference between the two groups(pp>0.05);35 days after operation,there was no significant difference between the two groups(p>0.05).5.There was no significant difference in preoperative hss score between the two groups(p>0.05),and there was significant difference between the two groups on the 7th day and 35 th day after operation(p<0.05).Conclusion: After tka anticoagulation based on the guidelines for the prevention of venous thromboembolism in Chinese orthopedic surgery,there are still some patients with deep venous thrombosis of lower extremity.However,compared with the routine anticoagulant method based on guidelines,the optimized anticoagulant method combined with Huoxue Tongmai tablet can further reduce the incidence of deep venous thrombosis in patients tka lower extremities after operation.It can relieve pain and swelling to some extent and accelerate postoperative rehabilitation.