| Objective:to observe the clinical effect and safety of acupoint application therapy combined with low molecular heparin in preventing the deep venous thrombosis of lower extremity after the total hip replacement,providing a basis for the further clinical application.Method:the diagnostic,inclusion and exclusion criteria for case selection were executed,70 cases of patient who was performed with an initial unilateral total hip replacement due to fracture of neck of femur or ischemic necrosis of femoral head in Development of orthopaedics of our hospital from 2015-12-1 to 2016-12-1 were collected and randomly divided into control group and experiment group based on the principle of random,with 35 cases for each group.The research program is as follows:control group:subcutaneously injected with low molecular heparin(fraxiparine)on hour 12 after operation,once a day,for 10 days successively,and concurrently administered with acupoint patch(placebo)at Geshu,Weizhong,Zushanli,Xuehai and Sanyinjiao on hour 12 after operation,10 stimulation points on the left and right side in total,each administration lasted for 4 hours,twice a day at 9:00 and 21:00,for 10 days successively.Experiment group:low molecular heparin was applied conventionally after operation(the specific operation was identical to that of control group).And the acupoint patch(Taohongsiwu decoction)was also applied to patient’s Geshu,Weizhong,Zusanli,Xuehai and Sanyinjiao(the specific operation was identical to that of control group)on hour 12 after operation concurrently.The distribution of preoperative(gender,age,height,weight,BMI,position of hip affected,complications of two diseases and preoperative complications)and intraoperative data(operation time,anesthesia time and bleeding amount)of both groups of patient were recorded,the main detection indexes(thrombelastogram,D-dimer and color Doppler ultrasound of deep veins of lower limb)and auxiliary dete.ction indexes(platelet count,hematocrit,hemoglobin,red blood cell count,perimeter of thigh,postoperative drainage volume and blood transfusion)1 day before operation and on day 2,6 and 10 after operation were examined and recorded.The occurrence of postoperative adverse reaction and treatment measure were observed,the correlation between them and this study was analyzed.The data was collected and a database was built,SPSS20.0 was used to carry out a statistical analysis on the difference in data between two groups.Result:①In this study,2 cases were terminated in control group,33 cases were finished finally,1 case was terminated in experiment group,34 cases were finished finally.The differences in the preoperative data of patients in both groups;gender,age,height,BMI,position affected,distribution of preoperative complications and patients with two types of disease between two groups were all not statistically significant(P>0.05),which were comparable;the differences in intraoperative data(operation time,anesthesia time and bleeding amount)between the patients in two groups were not statistically significant(P>0.05),which were comparable too.②For two groups,the differences between R,K,alpha angle,MA and CI value on day 2,6 and 10 after operation and the preoperative counterparts were statistically significant(P<0.05);the inter-group comparison on day 6 between two groups of K value and alpha angle was statistically significant(P<0.05),the inter-group comparison on day 6 and 10 between two groups of MA value and CI value was statistically significant(P<0.05);the experiment group had a evidently lower percentage of hypercoagulable state than the control group did on day 6 and 10 after operation,the difference was statistically significant(P<0.05).③ On day 6 and 10 after operation,the experiment group had a lower D-dimer than the control group did,the difference was statistically significant(P<0.05).④The control group was found to have 2 cases of complications of DVT after operation,the experiment group was found to have none,the control group(5.71%)was higher than experiment group(0.00%)in terms of incidence rate of deep venous thrombosis.⑤The differences between RBC,HB,HCT and PLT on day 2,6 and 10 after operation and the preoperative counterparts of two groups of patient were statistically significant(P<0.05),while inter-group comparison of RBC,HB and HCT at each time point were all not statistically significant(P>0.05),The inter-group comparison on day 6 and 10 between two groups of PLT was statistically significant(P<0.05).⑥On day 6 after operation,the swelling of thigh of the patients in experiment group was alleviated more significantly than that of the patients in experiment group was,the difference in perimeter of thigh was statistically significant(P<0.05).⑦The differences in postoperative drainage volume,number of patients who had blood transfusion and volume of blood transfusion between two groups were not statistically significant(P>0.05).⑧There were 2 cases of incision fat liquefaction,2 cases of urinary system infection and 1 case of pressure sores in the control group,while there were 1 case of incision fat liquefaction,1 case of urinary system infection,1 case of pressure sore and 1 case of skin allergy,the difference was not statistically significant(P>0.05).Conclusion:acupoint application therapy combined with low molecular heparin can significantly improve the hypercoagulable state of THA patients after operation,further reduce the risk of formation of DVT and simultaneously improve the swelling of lower limb of affected hip,and it also has a good safety and is easy to operate,the patients are highly compliant to it. |
