Effect Of Taohong Siwu Decoction On Prevention Of Deep Venous Thrombosis After PFNA Surgery In Elderly Patients With Intertrochanteric Fracture

Objective:To observe the clinical effect of modified Taohong Siwu Decoction on preventing deep vein thrombosis(DVT)of lower limbs after femoral proximal anti-rotation intramedullary nail(PFNA)for intertrochanteric fracture of femur(IFF)in the elderly,so as to optimize the prevention and treatment of clinical DVT and provide a new idea for TCM to participate in the prevention of postoperative DVT of intertrochanteric fractures after PFNA.Methods:Sixty subjects were selected,all of whom were treated at the Trauma C:enter of the Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January to February 2017,and met the requirements of the "Fighting Intertrochanteric Fracture-Single Disease Rapid Treatment Channel".Patients who were scheduled to undergo PFNA on the third day of admission.They were randomly divided into treatment group and control group,30 cases each.The control group was pre-operatively prepared immediately after admission,including preoperative education,routine preoperative examination,etc.,and PFNA treatment was performed on the third day after admission.Postoperative routine anticoagulant therapy was given:lower limb spacer pneumatic pump qd with low molecular weight Heparin calcium qd;On the basis of this,the treatment group instructed the patient to orally add the Taohong Siwu Decoction qd,which was treated until the 17th day of hospitalization(the 14th day after surgery).The pain visual analogue scale(VAS)were observed on the 2nd day of hospitalization,the 6th day of hospitalization(3rd day after surgery),and the 17th day of hospitalization(14th day after surgery).Two groups of patients were arranged for fasting serum prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-Dimer);Deep vein color Doppler ultrasound examination of the lower extremities,statistics of thrombosis and recorded in the table.Results:1.There were no significant differences in VAS,PT,APTT,FIB and D-Dimer between the two groups before surgery(the second day of hospitalization)(P>0.05).2.On the 6th day of hospitalization(3rd day after surgery)and the 17th day of hospitalization(14th day after surgery),the VAS scores of the treatment group were(3.98±0.44)、(1.13±0.18),VAS scores of the control group were(4.29±0.39)、(1.38±0.26);all were compared with preoperative(second in hospital)Day)significantly improved;comparison between groups,the above indicators in the treatment group were better than the control group(P<0.05);3.On the 6th day of hospitalization(3rd day after surgery)and the 17th day of hospitalization(14th day after surgery),the serum PT of the treatment group was(13.19±0.70)、(13.40±0.76),and the APTT was(34.47±4.02)、(35.04±3.93);serum PT of the control group were(12.85±0.73)、(13.03±0.72),and APTT was(32.40±4.28)、(32.89±4.35);all were compared with preoperative(the second day of hospitalization).Significantly fprolonged;the above indicators in the treatment group were significantly higher than the control group(P<0.05);4.(On the 6th day of hospitalization(day 3 postoperatively)and the 17th day of hospitalization(day 14th posloperatively),the serum FIB of the treatment group was(3.67±1.40)、(2.62±0.90),and D-Dimer was(1.98±1.16)、(1.67±1.06);serum FIB of the control group were(3.30±0.93)、(3.05±0.92),and D-Dimer was(2.161±1.26)、(1.87±1.08);The days were significantly lower.The serum D-Dimer was significantly lower than the control group(P<0.05).The serum FIB of the treatment group was higher than the control group on the 6th day(3rd day after surgery),but there was no statistical analysis.The significance(P>0.05),the 17th day of hospitalization(the 14th day after surgery)was significantly lower than the control group(P<0.05);5.On the 17th day of hospitalization(14th day after surgery),there were no deep vein thrombosis of the lower extremity in the treatment group,and 2 cases were found in the control group.There was no ob-vious discomfort after active thrombolytic therapy.Conclusion:Modified Taohong Siwu Decoction can significantly relieve in elderly patients with femoral intertrochanteric f-racture treated with PFNA postoperative pain symptoms,improve the hip joint activity function,improve blood high condensation state(PT↑、APTT↑、FIB↓、D-Dimer↓),prevent postoperative venous thrombosis and is worthy of clinical promotion.