| Objective:To observe the clinical efficiency of the combined treatment of supplementing Qi and promoting blood circulation with the use of pneumatic compression in the prevention of DVT in patients with malignant tumors of gastrointestinal tract receiving adjuvant chemotherapy.Methods:A total of 70 patients who received SOX or XELOX regimen for adjuvant chemotherapy suffering from malignant tumors of the digestive tract with extremely high-risk VTE scores were recruited for this study.They were randomly divided into experimental group and control group by numbers 1:1.A total of 68 patients completed the study,which are 34 in each the experimental group and control group.During the period of adjuvant chemotherapy,the control group received intermittent pneumatic compression therapy in both lower extremities,in a consistency of thrice a day,30 minutes during each session:the experimental group received”Yiqi Huoxue Decoction" on top of intermittent pneumatic therapy,one concoction a day,ingested twice daily.Their Caprini scores were recorded before commencing chemotherapy and recorded every two weeks.Blood routine and coagulation function were measured simultaneously to record the value of platelet count(PLT),D-2 polymer value,activated partial thrombin time(APTT),prothrombin time(PT),plasma fibrinogen count(FIB).B-mode ultrasonography of deep veins in lower extremities was examined every start of each chemotherapy and every two weeks after.Should there be any abnormal fluctuation above the recorded index values or discomfort,such as swelling and pain occurring during treatment,a color Doppler ultrasound should be used to exclude the possibility of DVT.Finally,the differences of Caprini score,PLT,D-2 polymer,APTT,PT and FIB between the two groups were compared.Followed-up three months,the patients were asked to undergo B-mode ultrasonography of deep veins of both lower extremities once a month.Meanwhile we will call them regularly by telephone to ask whether there were any discomforts such as swelling and pain of limbs,and recording whether there were thrombosis.Results:(1)The Caprini score,PLT,D-2 polymer,APTT,PT and FIB P values of the experimental group and the control group pre-treatment were all higher than 0.05,indicating that there were no significant differences between the two groups(P>0.05).(2)There was no statistical differences in the Caprini score,PLT,D-2,APTT and PT between the two groups after 2 cycles of adjuvant chemotherapy(P>0.05),but a statistical difference in FIB was found between both groups(P<0.05);no statistical difference in Caprini scores,PLT and D-2 polymer between the two groups were found after 4 cycles of adjuvant chemotherapy(P>0.05),but there was a statistical difference between APTT,PT and FIB groups(P<0.05);There was a statistical difference between the experimental group and the control group after 6 cycles of adjuvant chemotherapy in Caprini score,PLT,D-2,APTT,PT and FIB(P<0.05).(3)The values of PLT,D-2 polymer and FIB decreased post-treatment in both groups,while the values of APTT and PT showed an increment.(4)One patient in the experimental group showed signs of oedema in both lower limbs,accounting for hypoproteinemia;one patient in the control group complained of swelling and pain at opening of the deep vein catheterization of the upper limbs,accounting for both inflammation and abscess formation.(5)Regardless of the time of chemotherapy or follow-up,all the patients included did not have DVT formation.Conclusion:(1)The blood of patients suffering from malignant tumors of the gastrointestinal tract are hyper coagulant.Values of the Caprini score,PLT,D-2 polymer and FIB decreased,while the values of APTT and PT increased,indicating that both interventions could prevent deep venous thrombosis.(2)The combined therapy of Invigorating Qi and activating blood circulation with pneumatic compression can effectively prevent DVT,showing characteristics of cumulative time.The after effect is better than the use of pneumatic compression alone. |
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