穴位贴敷疗法联合磺达肝癸钠预防THA术后DVT形成的疗效观察

Effect of acupoint application combined with fondaparinux on prevention of DVT after THA

目的研究股骨颈骨折的老年患者在人工股骨头置换术后采用穴位贴敷疗法联合磺达肝癸钠预防下肢深静脉血栓的效果。方法选择2020年4月至2021年5月在珠海市中西医结合医院接受人工股骨头置换术治疗的老年股骨颈骨折患者40例,根据术后下肢深静脉血栓预防方法的不同将其分成对照组和治疗组,术后采用低分子肝素联合穴位贴敷安慰剂方式预防下肢深静脉血栓形成的20例为对照组,术后采用磺达肝癸钠联合穴位贴敷活血通络膏方式预防下肢深静脉血栓形成的20例为治疗组。比较两组术后下肢深静脉血栓形成情况、手术操作时间、术后疼痛消失时间、术后住院时间、髋关节功能恢复正常时间、骨折手术治疗效果、凝血功能、D-二聚体水平、血液流变学、血小板聚集率、血小板计数、心理状态、睡眠质量、生活质量评分。结果治疗组术后下肢深静脉血栓形成少于对照组,差异有统计学意义(P<0.05);手术操作时间、术后疼痛消失时间、术后住院时间、髋关节功能恢复正常时间短于对照组,差异有统计学意义(P<0.05);骨折手术治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗前后凝血功能、血液流变学、血小板计数、血小板聚集率、生活质量、心理状态、睡眠质量评分的改善幅度高于对照组,差异有统计学意义(P<0.05)。结论股骨颈骨折的老年患者在人工股骨头置换术后采用穴位贴敷疗法联合磺达肝癸钠进行治疗,可以预防下肢深静脉血栓形成,缩短手术操作时间、术后疼痛消失时间、术后住院时间、髋关节功能恢复正常时间,帮助改善凝血功能、血液流变学、血小板计数、血小板聚集率、生活质量、睡眠质量,使患者保持良好心态,提高疾病治疗效果。

Objective To study the effect of acupoint application combined with fondaparinux on the prevention of deep vein thrombosis of lower limbs in elderly patients with femoral neck fracture after artificial femoral head replacement.Methods A total of 40 elderly patients with femoral neck fracture underwent artificial femoral head replacement in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from April 2020 to May 2021 were selected.They were divided into the control group and the treatment group according to the different prevention methods of postoperative deep vein thrombosis of lower limbs.The control group included 20 patients treated with low molecular weight heparin combined with acupoint application of placebo after surgery to prevent deep venous thrombosis of lower limbs,and the treatment group included 20 patients treated with fondaparinux combined with acupoint application of Huoxue Tongluo Ointment after surgery to prevent deep venous thrombosis of lower limbs.The occurrence of postoperative deep vein thrombosis of lower limbs,operation time,postoperative pain disappearance time,postoperative hospital stay,hip joint function recovery time,fracture surgery treatment effect,blood coagulation function,D-dimer level,hemorheology,platelet aggregation rate,platelet count,sleep quality score,mental state,and quality of life were compared between the two groups.Results The occurrence of postoperative deep venous thrombosis of lower limbs in the treatment group was lower than that in the control group,with statistically significant difference(P<0.05).The operation time,postoperative pain disappearance time,postoperative hospital stay,and hip joint function recovery time in the treatment group were shorter than those in the control group,with statistically significant differences(P<0.05).The total effective rate of fracture surgery in the treatment group was higher than that in the control group,with statistically significant difference(P<0.05).The improvements of blood coagulation function,hemorheology,platelet count,platelet aggregation rate,quality of life,mental state,and sleep quality score after treatment in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Acupoint application combined with fondaparinux can prevent deep vein thrombosis of lower limbs,shorten operation time,postoperative pain disappearance time,postoperative hospitalization time and hip joint function recovery time in elderly patients with femoral neck fracture after artificial femoral head replacement.It can also improve coagulation function,hemorheology,platelet count,platelet aggregation rate,quality of life,and sleep quality,so that patients can maintain a good mental state,which improves treatment effect.