Clinical Study Of Sichong Tablet Combined With Low Molecular Weight Heparin In Preventing DVT Of Lower Limbs After Artificial Femoral Head Replacement For Elderly Femoral Neck Fractures

Objective:To observe the clinical effect of Sichong tablet combined with LMWH and LMWH alone in preventing lower limb DVT after AFHR for FNF in the elderly,explore its mechanism of action,provides a new clinical approach for the prevention of DVT of lower limbs after AFHR with integrated traditional Chinese and western medicine.Methods:A total of 60 patients with femoral neck fracture aged ≥70 years and undergoing AFHR surgery admitted to the orthopaedic ward of Shandong Hospital of TCM from September 2019 to September 2020 were selected for this study,randomly divide the subjects into a test group and a control group,both groups of patients were given basic treatment and prevention of thrombosis according to guidelines.After the operation,the test group received oral Si Chong tablet combined with subcutaneous injection of LMWH,and the control group received simple subcutaneous injection of low molecular heparin.Record and compare the basic data of the two groups of patients,observation index(D-Dimer,Fib,APTT,PT,VAS pain score,the circumference of the affected thigh)before operation and after 1,7,and14 days and Color Doppler ultrasonography results of the lower extremity deep veins before and on the 14 th day after surgery,record the occurrence of adverse reactions and events.All research data were analyzed by SPSS25.0 statistical software,and P<0.05 was considered as statistically significant.Results:1.The two groups of data were compared in basic data such as gender,age,body mass index,time from injury to waiting for operation,operation time,combined with underlying diseases,and the differences were not statistically significant(P>0.05),indicating that the two groups of data are comparable.2.D-Dimer and Fib:The two groups of patients were compared within the group before the operation and on the 1,7,and 14 days after the operation,and the results were statistically significant(P<0.05);the two groups of patients were compared between the groups at the same time point,and there was no statistically significant in the two groups(P>0.05).3.APTT and PT:The two groups of patients were compared within the group before the operation and on the 1,7,and 14 days after the operation,and the results were statistically significant(P<0.05);the two groups of patients were compared between the groups at the same time point,there was no statistically significant difference in changes between preoperative and postoperative days 1 and 7(P>0.05),and the difference in changes on the 14 th day after operation was statistically significant(P<0.05).4.VAS pain score:The two groups of patients were compared within the group before the operation and on the 1,7,and 14 days after the operation,and the results were statistically significant(P<0.05);the two groups of patients were compared between the groups at the same time point,there was no statistically significant difference in changes before and on the1 st and 14 th days after surgery(P>0.05),and the differences in changes on the 7th day after surgery were statistically significant(P<0.05).5.The circumference of the affected thigh:The two groups of patients were compared within the group before the operation and on the 1,7,and14 days after the operation,and the results were statistically significant(P<0.05);the two groups of patients were compared between the groups at the same time point.There was no statistically significant difference in changes on the 1st day(P>0.05),and the difference in changes on the 7th and 14 th day after operation was statistically significant(P<0.05).6.Postoperative DVT occurrence:No patient in the test group developed DVT of the lower extremity,and 1 patient in the control group developed DVT of the lower extremity,which was a thrombosis of the calf inter-muscle vein.Comparison of the two groups of data,the difference was not statistically significant(P>0.05).7.Safety monitoring:During the study period,the two groups of patients had no obvious bleeding tendency,there were no adverse reactions such as drug allergic reactions,gastrointestinal bleeding,wound infection,liver and kidney damage,pulmonary embolism,etc.The postoperative incision healed well,and the exudates were normal.There were no obvious abnormalities in the laboratory test items.The mild skin and mucosal ecchymosis after the operation of the two groups of patients were normal.Conclusion:Sichong tablet combined with LMWH can effectively improve the hypercoagulable state of blood after AFHR for elderly FNF,can effectively relieve postoperative pain,reduce postoperative swelling of the affected limb,and prevent DVT,analgesia,and swelling of lower limbs.It is superior to LMWH in terms of prevention of lower limb DVT,analgesia,and swelling.It has certain safety and effectiveness.