Clinical Study Of Acupoint Electrophysiological Technique For Preventing VTE After Gynecological Malignant Tumor Operation

Objective(s):To explore the efficacy and safety of acupoint electrophysiology in preventing Venous thromboembolism after gynecological malignant tumor surgery,and to provide reference basis and new therapeutic ideas for reducing VTE after gynecological malignant tumor surgery in clinical work.Methods:A total of 100 patients(29 cases of cervical cancer,48 cases of endometrial cancer,and 23 cases of ovarian cancer)who received surgical treatment in our hospital from January 2021 to December 2022 were selected,with Caprini risk score ≥5 points.The study subjects were randomly divided into 2 groups: experimental group(n=50)and control group(n=50).The experimental group was treated with intermittent inflatable pressure pump and acupoint electrophysiological therapy after surgery,each mechanical prevention twice a day,30 minutes each time.Acupoint electrophysiological treatment was low-frequency electrical stimulation(frequency 10 HZ,pulse width 300 us,saan-type wave,continuous platform time).Acupoints were selected: Taixi,Zusanli,Sanyinjiao and Yinlingquan.The control group was treated with intermittent inflatable pressure pump twice a day for 30 minutes each time(same as the experimental group).The starting time of mechanical prophylaxis was 6 hours after operation,and enoxaparin anticoagulation therapy was given to both groups 24 hours after operation.The average femoral vein flow velocity of the two groups was compared before surgery,after surgery(before treatment),the first day after operation(D1),the second day after operation(D2),the 3rd day after operation(D3)and the 7th day after operation(D7).Incidence of venous thromboembolism(VTE)within 7days after surgery in both groups.The coagulation indexes(D-dimer),blood analysis related indexes(PLT and inflammation index NLR: neutrophil /lymphocyte ratio)and infection index(PCT)were compared between the two groups before operation,on the 1st day(D1),3rd day(D3)and 7th day after operation(D7).Fasting blood samples were taken from two groups(experimental group(n=31)and control group(n=30)before and after mechanical prophylaxis treatment(7 days after operation).The relative expression of circulating tumor cell markers(CK19 m RNA)in peripheral blood was detected by q RT-PCR method to evaluate the safety of the new technique.Results:1.The incidence of VTE was 10%(5/50)in the experimental group and30%(15/50)in the control group.The incidence of VTE in the experimental group was significantly lower than that in the control group(P < 0.05).2.After the intervention,the velocity of femoral vein in the experimental group was significantly faster than that of the control group on the 1st,2nd,3rd and 7th day after the operation,the difference was statistically significant(P < 0.001).3.On the 1st and 3rd day after operation,the derivative inflammatory index NLR in the two groups was higher than that before operation,and decreased on the 7th day after operation.On the third day after surgery,the NLR of the control group was significantly higher than that of the experimental group,with statistical significance(P < 0.05).4.Inflammation index PCT of the two groups increased gradually on the1 st and 3rd day after surgery,and decreased on the 7th day after surgery.PCT of the control group was significantly higher than that of the experimental group on the 3rd day after surgery,with statistical significance(P< 0.05).5.The levels of platelet and D-dimer in the two groups were gradually increased on the 1st,3rd and 7th day after operation,especially in the control group,but there was no significant difference between the two groups(P >0.05).6.There was no significant difference in the relative expression of tumor marker CK19 m RNA in peripheral blood between the two groups before and after treatment(P > 0.05).Conclusion(s):1.The effect of acupoint electrophysiological technique combined with intermittent inflatable pressure pump in preventing venous thrombosis after gynecological malignant tumor operation is better than that of intermittent inflatable pump.2.Acupoint electrophysiological technique can promote lower limb blood circulation and improve inflammation after gynecological malignant tumor surgery,and play a certain role in preventing VTE after gynecological malignant tumor surgery.3.The increase of circulating tumor cells was not observed after acupoint electrophysiological treatment,so it is safe to some extent.