Clinical Observation On The Application Of Traditional Chinese Medicine To Prevent Deep Venous Thrombosis After Arthroscopy Of Knee Osteoarthritis

Objective:To evaluate the efficacy and safety of deep vein thrombosis?DVT?risk treated with Taohong Siwu Decoction after arthroscopic debridement for patients more than 60 years old with knee osteoarthritis?KOA,grade I or II?and at high risk or very high risk for DVT evaluated with Caprini risk assessment.Methods:A retrospective analysis of 63 elderly patients with KOA?grade I or II?at high risk or very high risk for DVT evaluated with Caprini risk assessment treated with arthroscopic debridement in Hubei Provincial Hospital of TCM from October 2015 to May 2017,those patients were divided into 2 groups according to the treatment after arthroscopic debridement:the control group?30 patients?was subcutaneously injected with low molecular weight-heparin?LMWH?,11 males and 19 females,average age was 61.3±9.7 years old?60to 79 years old?.The Kellgren-Lawrance classification I,14 cases,II,16 cases.10 at high risk,20 at very high risk of DVT evaluated by Caprini assessment model assessment.33 patients,13 males and20 females,in observation group were treated with Taohong Siwu Decoction,the average age was 63.4±10.1 years old?60 to 81years old?,the Kellgren-Lawrance classification I,15 cases,II,18 cases,and 12 at high risk,21 at very high risk of DVT evaluated by Caprini assessment model assessment.Pre-operation or post-operation(1^th,3^th and 7^th day)biochemical and hematological variables,routine blood indexes and symptoms in 2 group patients were recorded and analyzed,such as D-Dimer?D-D?,activated partial thromboplastin time?APTT?,platelet?PLT?,fibrinogen?FIB?,hemoglobin?Hb?,erythrocyte specific volume?Hct?,visual analogue scale?VAS?,circumferential diameter of the affected side.The postoperative wound conditions of the 2 groups were compared,the drainage tube was removed on the second day,and the flow rate of 2 groups was recorded.At 7^th day post-operation,Color Doppler ultrasound?CDU?was performed to determine the incidence of DVT for 2 group patients.Results:There were no statistically significant differences?all p_>0.05,observation group to control group?between two groups about D-D,APTT,PLT,FIB,Hb,Hct,VAS,and the circumferential diameter of the thigh before operation and 1^thh day post-operation.However,there were significantly differences?all p_<0.05?between pre-operation and 1-day post-operation for D-D,APTT,PLT,FIB,Hb,Hct in two groups,respectively.The most importantly,D-D,PLT,FIB,Hb,Hct were significantly higher?all p_<0.05,observation group versus control group?and APTT and VAS were significantly alleviated?all p_<0.05,observation group versus control group?at3^th and 7^th day post-operation and the drainage of the tube was less?p_<0.05,observation group to control group?.But,the morbidity of DVT was no significantly differences?p_>0.05,observation group to control group?.Conclusion:for patients more than 60 years old with KOA?grade I or II?and at high risk or very high risk for DVT,compared with LMWH,Taohong Siwu Decoction could accelerate the swelling subsided,alleviate pain,reduce recessive blood loss,furthermore,Taohong Siwu Decoction could also improve the quality of life and was worthy to be popularized in clinic.