低分子肝素联合温针灸及穴位贴敷治疗预防下肢骨折患者术后DVT形成的临床研究

Clinical Study on Low Molecular Weight Heparin Combined with Warm Acupuncture and Moxibustion and Point Application to Prevent DVT Formation after Lowen Limb Fracture

目的:研究低分子肝素(LMWH)联合温针灸及穴位贴敷对于下肢骨折患者术后深静脉血栓(DVT)的预防效果。方法:选取2021年4月—2023年3月上海沪东医院收治的70例行下肢骨折手术的患者作为研究对象,按照随机数表法分为对照组与试验组,每组各35例,分别采用LMWH皮下注射治疗与此基础上加用温针灸及穴位贴敷,观察两组术后DVT发生情况、手术前后血栓弹力图(IEG)及相关血液指标检测结果。结果:两组术后DVT发生率,差异无统计学意义(P>0.05);TEG检测中试验组术后7 d时凝血指数、血块动力及血块强度均显著低于对照组,血液凝固时间显著高于对照组,差异有统计学意义(P<0.05);D-二聚体(D-D)及血小板计数(PLT)显著低于对照组,差异有统计学意义(P<0.05)。结论:对下肢骨折手术患者采用LMWH联合温针灸及穴位贴敷进行预防性治疗,能够改善患者下肢血液循环,有效降低DVT发生风险,且未见不良反应发生。

Objective:To study the preventive effect of low molecular weight heparin(LMWH)combined with warm acupuncture and moxibustion and acupoint application on deep vein thrombosis(DVT)after lower limb fracture surgery.Method:From April 2021 to March 2023,70 patients with lower limb fracture who were enrolled in the orthopaedics department of Shanghai Hudong Hospital.They were randomly divided into the control group and the test group,with 35 cases in each group.LMWH subcutaneous injection was used and warm acupuncture and acupoint application were added on the basis of LMWH.The occurrence of DVT after surgery,thromboelastogram before and after surgery,and the detection results of related blood indicators were observed in the two groups.Result:There was no significant difference in the incidence of postoperative DVT between the two groups of patients(P>0.05).In TEG testing,the coagulation index,blood clot motility,and blood clot strength of the experimental group were significantly lower than those of the control group 7 days after surgery,and the blood coagulation time was significantly higher than that of the control group(P<0.05).The D-dimer and platelet counts were significantly lower than those of the control group(P<0.05).Conclusion:The prophylactic treatment of LMWH combined with warm acupuncture and moxibustion and acupoint application for patients with lower limb fracture surgery can improve the blood circulation of patients with lower limb fractures,effectively reduce the risk of DVT,and no adverse reactions occur,which is worth further promotion in clinical practice.