Effect Of Transcutaneous Electrical Acupoint Stimulation Combined With Acupoint-injection Of Lappaconitine On Deep Venous Thrombosis After Total Knee Arthroplasty

Objective: To investigate the effect of transcutaneous electrical acupoint stimulation combined with acupoint-injection of lappaconitine on deep venous thrombosis after total knee arthroplasty,and to provide a new way to prevent deep vein thrombosis by combining traditional Chinese and western medicine.Methods: A total of 90 patients with total knee arthroplasty that met the inclusion criteria were randomly divided into TEAS combined with acupoint injection group(S group),TEAS group(T group)and control group(D group),30 cases each.The control group(group D)was routinely treated with LMWH sodium injection to prevent DVT.TEAS group(T group)underwent Transcutaneous electrical acupoint stimulation on the basis of control group.S group underwent transcutaneous electrical acupoint stimulation combined with acupoint-injection intervention was performed on the basis of the control group.Compared three groups of patients with postoperative incidence of deep vein thrombosis,collect three groups of patients with venous blood samples to test the coagulant function index in preoperative and postoperative 1 d,3 d,7 d,collect three groups of patients with venous blood samples to test the cortisol and adrenocorticotropic hormone levels in after anesthesia before surgery,postoperative immediately,24 hours after surgery.Results:(1)87 patients(30 in group D,28 in group T and 29 in group S)who completed the research plan and had complete observation data.The age,gender composition,weight and intraoperative blood transfusion volume of the three groups were compared,and the differences were not statistically significant.(2)postoperative incidence of deep venous thrombosis: color doppler ultrasonography showed that deep venous thrombosis occurred in 2/30(6.67%)patients in group D,1/28(3.57%)patients in group T,and no deep venous thrombosis in group S.(3)coagulation index: there was no significant difference in preoperative prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and d-dimer(d-dimer)between the three groups(P>0.05).On day 1,3 and 7 after surgery,PT and APTT in group S were significantly longer than those in group T and D(P<0.05),and PT and APTT in group T were significantly longer than those in group D(P<0.05).FIB in group S was significantly lower than that in group T and D(P<0.05),and FIB in group T was significantly lower than that in group D(P<0.05).D-dimer of T group and S group was significantly lower than that of D group on day 1,3 and 7 after surgery(P<0.05),and D-dimer of S group was significantly lower than that of T group on day 1 after surgery(P<0.05),but there was no significant difference between S group and T group on day3 and 7 after surgery(P>0.05).(4)stress level: there was no statistically significant difference in cortisol(COR)and adrencocorticotropic hormone(ACTH)between the three groups before anesthesia surgery(P>0.05).However,COR and ACTH in the S group were significantly lower than those in the T group and the D group(P<0.05),and COR and ACTH in the T group were significantly lower than those in the D group(P<0.05).Conclusion: Transcutaneous electrical acupoint stimulation combined with acupoint injection of lappaconitine can significantly reduce perioperative stress response level,improve postoperative coagulation function of patients,and play a positive role in preventing the formation of deep venous thrombosis after total knee arthroplasty.