| ObjectiveTo observe the clinical effect of Pingle Guo's prescription in preventing lower limb deep venous thrombosis after total hip replacement in elderly patients with femoral neck fracture,and to explore its mechanism,providing a clinical prevention and treatment program for the prevention of deep venous thrombosis of lower limbs af ter major orthopaedic surgery.Methods60 elderly patients with femoral neck fracture underwent total hip arthroplasty in Shenzhen Pingle Orthopedic Hospital from January 2018 to January 2019 were selected,they were randomly divided into treatment group and control group with 30 cases in each group by SAS statistical software.The treatment group was treated with Pingle Guo's prescription(Hongtao Xiaozhong Heji)from 1 day to 14 days after operation,while the control group was treated with subcutaneous injection of Nadroparin Calcium Injection.The D-dimer,contractinogen,prothrombin time,activated partial thromboplastin time,thigh circumference of affected side and the results of color Doppler ultrasonography of deep venous vessels of extremities were observed and compared between the two groups before and 1,4,7 and 14 days after operation.And record the occurrence of adverse reactions or events.ResultsComparison of two groups of patients with basic data,the difference was not statistically significant(P>0.05).There was no significant difference in D-dimer,contractinogen,prothrombin time,activated partial thromboplastin time and thigh circumference of affected side between the two groups before surgery(P>0.05).On the 1st day after operation,the levels of d-dimer,contractinogen and thigh circumference of affected side in the two groups were significantly higher than those before surgery(P<0.01),the prothrombin time and the activated partial prothrombin time in the two groups were significantly shorter than those before surgery(P<0.01),and there was no significant difference between the two groups(P>0.05).On the 4th day after operation,D-dimer in the treatment group was higher than that before operation(P<0.01),while the d-dimer level in the control group was not significantly different from that before surgery(P>0.05),and there was no significant difference between the two groups(P>0.05);The levels of contractinogen in the two groups were higher than those before operation(P<0.01),and there was no significant decrease compared with the first day after operation(P>0.05),It was no significant difference between the two groups(P>0.05);The prothrombin time of the two groups was shorter than the preoperative level(P<0.01),and it was no significant prolongation compared with the first day after operation(P>0.05),there was no significant difference between the two groups(P>0.05);Two groups of activated partial thromboplastin time were shorter than the preoperative le-vel(P<0.01),but there were longer than the first day after operation and the control group was more prolonged(P<0.05);Two groups of thigh circumference of affected side were longer than that of the preoperative and the first day after operation(P<0.01),and there was no significant difference between the two groups(P>0.05).On the 7th day after operation,The levels of D-dimer in the two groups were no significant difference before operation(P>0.05),but it was significantly lower than that on the 1st day after operation(P<0.01),there was no significant difference between the two groups(P>0.05);Contractinogen in the treatment group was higher than that before operation(P<0.01),but it was no significant difference compared with the first day after operation(P>0.05);Contractinogen in the control group was not significantly different from that before operation(P>0.05),but which was significantly lower than that on the first day after operation(P<0.01);There was significant difference in contractinogen between the two groups on the 7th day after operation(P<0.05).Prothrombin time in both groups was longer than that before operation(P<0.01),which was significantly longer than that on the first day after operation(P<0.01),and it was no significant difference between the two groups(P>0.05);Activated partial thromboplastin time in both groups was no significant difference than that before operation(P>0.05),but it was significantly longer than that on the first day after operation(P<0.01),and there was no significant difference between the two groups(P>0.05);Thigh circumference of affected side in the treatment group was longer than the preoperative level(P<0.01),which was not significantly different from the first day after surgery(P>0.05),and significantly shorter than the control group(P<0.05),thigh circumference of affected side in the control group was longer than that before surgery and on the first day after surgery(P<0.01).On the 14th day after operation,the level of D-dimer in the treatment group was no significant difference than that before operation(P>0.05),which was significantly lower than that on the first day after surgery(P<0.01),and the level of D-dimer in the control group was lower than that before operation(P<0.05),which was significantly lower than the first day after surgery(P<0.01);There was no significant difference between the two groups(P>0.05).Contractinogen in the two group was no significant difference than that before operation(P>0.05),which was significantly lower than that on the first day after surgery(P<0.05),there was no significant difference between the two groups(P>0.05).The prothrombin time in both groups was longer than that before operation(P<0.01),significantly longer than that on the first day after operation(P<0.01),and the control group was significantly longer than the treatment group(P<0.05).The activated partial thromboplastin time of the two groups was not significantly different from that before operation(P>0.05),which was significantly longer than that on the first day after operation(P<0.01),and that of the control group was significantly longer than that of the experiment(P<0.05).Thigh circumference of affected side in the treatment group was not significantly different from that before operation(P>0.05),but which was significantly shorter than that on the first day after operation(P<0.05),and significantly shorter than that of the control group(P<0.05),the thigh circumference of the affected side in the control group was longer than that before operation and on the first day before and after operation(P<0.01).Bonferroni test showed that there was no significant difference in the ensemble average of D-dimer and contractinogen between the two groups(P>0.05).The ensemble average of prothrombin time and activated partial thromboplastin time in the treatment group were shorter than those in the control group(P<0.05).On the 14th day after operation,no deep venous thrombosis was found in both groups.No adverse reactions or incidents occurred in each group during the study.Conclusion1.In the elderly patients with femoral neck fracture,the blood was in a state of high coagulation within 14 days after total hip arthroplasty,which was easy to induce deep vein thrombosis in lower limbs.The risk was particularly significant within 7 days after surgery,and effective intervention measures should be given.2.Both Hongtao Xiaozhong Heji and Nadroparin Calcium Injection can effectively prevent deep vein thrombosis of lower limbs after total hip arthroplasty,the mechanism may be achieved by down-regulating D-dimer,contractinogen,prolonging thromboplastin time and activating partial thromboplastin time.3.Hongtao Xiaozhong Heji is better than Nadroparin Calcium Injection in eliminating swelling.4.Hongtao Xiaozhong Heji has fewer adverse reactions and is safe for clinical application. |
PDF Full Text Request