Efficacy of percutaneous mechanical thrombus removal in acute lower extremity deep venous thrombosis

BACKGROUND Acute lower extremity deep venous thrombosis(LEDVT)is a common vascular emergency with significant morbidity risks,including post-thrombotic syndrome(PTS)and pulmonary embolism.Traditional treatments like catheter-directed thrombolysis(CDT)often result in variable success rates and complications.AIM To investigate the therapeutic efficacy of percutaneous mechanical thrombus removal in acute LEDVT.METHODS A retrospective analysis was performed to examine 58 hospitalised patients with acute LEDVT between August 2019 and August 2022.The patients were categorised into the percutaneous mechanical thrombectomy(PMT)group(n=24)and CDT group(n=32).The follow-up,safety and treatment outcomes were compared between the two groups.The main observational indexes were venous patency score,thrombus removal effect,complications,hospitalisation duration and PTS.RESULTS The venous patency score was 9.04±1.40 in the PMT group and 8.81±1.60 in the CDT group,and the thrombus clearance rate was 100%in both groups.The complication rate was 8.33%in the PMT group and 34.84%in the CDT group,and the difference was statistically significant(P<0.05).The average hospitalisation duration was 6.54±2.48 days in the PMT group and 8.14±3.56 days in the CDT group.The incidence of PTS was lower in the PMT group than in the CDT group;however,the difference was not statistically significant(P<0.05).CONCLUSION Compared with CDT,treatment of LEDVT via PMT was associated with a better thrombus clearance rate,clinical therapeutic effect and PTS prevention function,but the difference was not statistically significant.Moreover,PMT was associated with a reduced urokinase dosage,shortened hospitalisation duration and reduced incidence of complications,such as infections and small haemorrhages.These results indicate that PMT has substantial beneficial effects in the treatment of LEDVT.

Clinical Value of Predictive Nursing Intervention on Deep Venous Thrombosis of Lower Extremities after Cesarean Section

[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation.

Deep Venous Thrombosis: Commonly Affected Veins in the Lower Limbs

Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT). Materials and Methods: A descriptive retrospective study of 46 already diagnosed cases of lower limb DVT. Results: Out of 46 cases of DVT, 71.74% were females. The majority of patients (93.47%) were affected in unilateral lower limb with significant predominance (65.22%) to affect the left lower limb (p Conclusion: Lower limb deep venous thrombosis affects left lower limb more than right and females more than males. Superficial femoral vein (SFV) and common femoral vein (CFV) are the most common affected veins. Lower limb DVT predominantly present in acute stage with venous distension and absent blood flow.

Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients

Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results：Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion：Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

Combined effect of Traditional Chinese Medicine decoction and low-molecular-weight heparin calcium on the postoperative deep venous thrombosis in patients with lower limb fracture

OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.

Prevention and Treatment of Deep Vein Thrombosis of the Lower Limbs in Patients with Complications after Orthopedic Trauma Surgery

Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.

Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.

Clinical Application of Percutaneous Transluminal Angioplasty and Stent Implantation in Acute Lower Extremity Deep Venous Thrombosis

Purpose: To analyze the application of percutaneous transluminal angioplasty and stenting in acute deep venous thrombosis of lower extremities. Methods: 70 patients were divided into two groups according to the presence or absence of percutaneous transluminal angioplasty and stenting. Results: The mean circumferential diameter difference between the affected limbs and the healthy limbs and the knees at 15 cm was statistically significant. The cure rate and effective rate of the research group were higher than those of the control group (P<0.05). Conclusion: Percutaneous transluminal angioplasty and stenting are of high value in acute lower extremity deep venous thrombosis.

Discussion on Prevention and Treatment of Lower Extremity Deep Venous Thrombosis in Orthopedic Perioperative Period from Spleen and Stomach Meridians

Deep venous thrombosis of lower extremity is one of the common complications in orthopedic perioperative period.It is caused by many factors,such as peripheral vein dilation,slow blood flow;long-term immobilization,bed rest and so on.On the one hand,it affects the early postoperative functional exercise and functional recovery,on the other hand,it increases the length of hospital stay and economic burden,increases the pain of patients and even endangers their lives.Effective treatment of traditional Chinese medicine combined with western medicine can play a better role in the prevention and treatment of lower extremity deep venous thrombosis.This study expounds the concept of spleen and stomach meridians in the prevention and treatment of lower extremity deep venous thrombosis,and puts forward some opinions on the dialectical treatment and daily conditioning of lower extremity deep venous thrombosis,hoping to provide ideas for the clinical prevention and treatment of lower extremity deep venous thrombosis in traditional Chinese medicine.

Two-point compression ultrasonography: Enough to rule out lower extremity deep venous thrombosis?

BACKGROUND: Deep venous thrombosis(DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department(ED). Point-of-care two-point compression ultrasonography has evolved as a quick and effective way of diagnosing DVT. The purpose of this study is to validate the prevalence and distribution of venous thrombi isolated to proximal lower extremity veins, other than common femoral and popliteal veins in patients with DVT.METHODS: This is a single-center retrospective study that looked at patients presenting to the ED of a tertiary care hospital between January 2014 and August 2018. The clinical presentation and laboratory and imaging results were obtained using the hospital's electronic medical record.RESULTS: A total of 2,507 patients underwent a lower extremity duplex ultrasound during the study period. Among them, 379(15%) were included in the study. The percentages of isolated thrombi to the femoral vein and deep femoral vein were 7.92% and 0.53%, respectively. When the patients were stratified into the two groups of isolated DVT and two-point compression DVT, there were no statistically significant differences in the laboratory results between both groups. However, immobilized patients and patients with recent surgeries were more likely to have an isolated DVT.CONCLUSIONS: Thrombi isolated to proximal lower extremity veins other than the common femoral and popliteal veins make up 8.45% of DVTs. Given this significant number of missed DVTs, the authors recommend the addition of the femoral and deep femoral veins to the two-point compression exam.

Analysis of curative effect of Bingxiao powder on lower limb deep vein thrombosis

Objective:To investigate the therapeutic effect of Bingxiao powder on edema caused by deep venous thrombosis in lower limb thrombosis.Methods:Selected in our hospital from September 2017 to April 2019 of 122 patients with lower limb deep vein thrombosis caused by edema.The patients were divided into two groups:Bingxio powder(61 cases)and magnesium sulfate(61 cases),the circumference difference of lower leg and thigh,the integral of edema and pain,the effective rate and the satisfaction rate of curative effect were compared between the two groups of patients with edema caused by thrombosis of lower limb.Results:in the observation group,the peripheral diameter difference of calf(1.08±0.21)cm,the peripheral diameter difference of thigh(1.76±0.28),the edema score(1.09±0.22)and the pain score(1.34±0.25)were all lower than those of the control group(P<0.05).The effective rate(95.08%)and satisfaction rate(96.72%)of the observation group were higher than those of the control group(P<0.05).Conclusion:Bingxiao powder can reduce the edema symptoms and pain symptoms of patients with edema caused by deep venous thrombosis of lower limbs,and reduce the circumference difference of the lower leg and thigh,with significant clinical effect.

Predictive Value of Systemic Immune Inflammation Index, Aggregate Index of Systemic Inflammation, and Systemic Inflammation Response Index in Lower Extremity Deep Venous Thrombosis Following Severe Trauma

Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis(LEDVT)in a severely traumatized population and to evaluate their predictive value for LEDVT.Methods This was a retrospective,single-center observational study.All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024.Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury,patients who developed LEDVT were enrolled in the LEDVT group,and those who did not develop LEDVT were enrolled in the NLEDVT group.Demographic,clinical,and laboratory data were collected upon admission.Multivariable logistic regression analysis was performed to identify risk factors for LEDVT.Receiver operating characteristic(ROC)curve was used to evaluate the overall fit of the final model.Results There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age,Aggregate Index of Systemic Inflammation(AISI),Systemic Inflammation Response Index(SIRI),ICU length of stay,and albumin were identified as independent risk factors for LEDVT(all P<0.05).The area under their ROC curves were 0.604,0.657,0.694,0.668,and 0.405,respectively.Combined model for early clinical prediction of LEDVT in severely traumatized patients by age,SIRI,AISI,and albumin resulted in an area under the ROC curve of 0.805(95%CI:0.73-0.88,SE=0.037).Conclusion The combination of age,SIRI,AISI,and albumin has a predictive value for LEDVT in severely traumatized patients.

丹参红花方联合LMWH对老年髋部骨折快速康复患者凝血功能及下肢血栓预防的治疗价值

目的观察丹参红花方联合低分子肝素(low molecular weight heparin,LMWH)在老年髋部骨折快速康复治疗过程中对凝血功能及下肢深静脉血栓(lower extremity deep vein thrombosis,LDVT)的临床影响。方法以绍兴市中医院关节骨科2022年10月—2023年4月收治的68例老年不稳定型股骨颈骨折入院72 h内行全髋关节置换术的快速康复治疗患者为研究对象,随机分为两组,对照组34例予低分子肝素钠术后预防性抗凝治疗,治疗组34例予丹参红花方联合低分子肝素钠治疗。记录两组患者手术前后的凝血酶原时间测定(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体、血浆AT-Ⅲ的水平变化及LDVT的发生情况,对两组数据进行统计分析。结果最终完成试验60例,治疗组30例,对照组30例。经统计两组患者术前PT、APTT、TT、D-二聚体、血浆AT-Ⅲ的水平差异无统计学意义(P>0.05);术后第1天、术后第5天,治疗组PT、APTT、TT较同期对照组有所延长(P<0.05),D-二聚体水平较同期对照组下降(P<0.05),血浆AT-Ⅲ活性水平较同期对照组明显提高(P<0.05);术后LDVT事件对比,治疗组较对照组减少(P<0.05)。结论老年髋部骨折快速康复治疗患者的治疗过程中,术后运用丹参红花方联合LMWH的患者,能够有效改善患者凝血功能,明显降低术后D-二聚体水平,提高血浆AT-Ⅲ活性水平,减少术后LDVT发生率,在老年髋部骨折快速康复治疗过程中具有积极意义。

炎症因子及凝血指标在下肢深静脉血栓形成中的检测价值

目的:分析炎症因子及凝血指标在下肢深静脉血栓形成中的检测价值。方法:选择2020年2月—2023年4月苏州市相城人民医院收治的65例下肢深静脉血栓患者作为观察组,另选择同期于本院体检的65例健康志愿者作为对照组;按照病程将观察组分成甲组(病程≤30 d)、乙组(病程>30 d)。比较各组的炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL6)、γ干扰素(IFN-γ)]、凝血指标[D-二聚体(D-D)、凝血因子Ⅷ(FⅧ)、凝血因子Ⅳ(FⅣ)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]。结果:观察组CRP、IL-6、IFN-γ、D-D水平均高于对照组,TT长于对照组,PT、APTT均短于对照组,差异均有统计学意义(P<0.05)。甲组CRP、IL-6、IFN-γ、D-D水平均高于乙组,TT长于乙组,PT、APTT均短于乙组,差异均有统计学意义(P<0.05)。结论:检测炎症因子、凝血指标水平有助于了解下肢深静脉血栓患者与健康人之间的区别,判断下肢深静脉血栓形成病程,为下肢深静脉血栓的早期诊断、疾病监测提供参考数据。

集束化护理对预防缺血性脑卒中后下肢深静脉血栓形成的效果

目的探讨集束化护理干预对于减少缺血性脑卒中患者并发下肢深静脉血栓的疗效。方法选取自2023年1月至2023年12月,在本院接受治疗的60例缺血性脑卒中患者作为样本,所有患者在入院后均接受标准溶栓治疗。通过随机数字表法将这些患者分为常规护理的对照组和集束化护理的观察组,每组各30例。对照组采用传统的护理措施,观察组采用集束化护理干预。对比两组患者下肢深静脉血栓的发生率,并对两组的凝血功能指标及下肢深静脉血栓健康信念量表评分进行对比分析。结果观察组的下肢深静脉血栓发生率较对照组低(P<0.05);在下肢深静脉血栓健康信念量表的各个维度评分中,观察组均高于对照组(P<0.05);在凝血功能指标方面,护理后观察组的凝血酶原时间(PT)、凝血酶时间(TT)和凝血活酶时间(APTT)均高于对照组,而纤维蛋白原(Fbg)水平低于对照组(P<0.05)。结论针对缺血性脑卒中患者开展集束化护理工作,可以强化其下肢深静脉血栓形成的健康信念,降低下肢深静脉血栓形成发生率。

多学科联合五阶梯渐进式活动方案在ICU机械通气病人中的应用

目的:探究多学科联合五阶梯渐进式活动方案在重症监护病房(ICU)机械通气病人中的应用效果。方法:选取2022年5月—2023年7月就诊于青岛市某医院的ICU机械通气病人为研究对象,根据入院时间将病人分为对照组(49例)和干预组(48例)。对照组采用重症常规治疗与护理方法进行干预,干预组采用多学科联合五阶梯渐进式活动方案进行干预。比较两组病人ICU获得性衰弱(ICU-AW)发生率、日常生活活动能力、ICU获得性谵妄发生率、机械通气时长、ICU住院时间、下肢深静脉血栓发生率。结果:干预组病人Barthel指数为(29.48±14.26)分,高于对照组[(17.14±14.25)分];机械通气时间为(5.56±3.75)d,ICU住院时间为(8.15±3.94)d,短于对照组[机械通气时间为(7.92±6.28)d,ICU住院时间为(11.69±8.73)d];ICU-AW发生率为17%,ICU获得性谵妄发生率为2%,下肢深静脉血栓发生率为21%,低于对照组[ICU-AW发生率为37%,ICU获得性谵妄发生率为27%,下肢深静脉血栓发生率为49%],差异均有统计学意义(均P<0.05)。结论:实施多学科联合五阶梯渐进式活动方案有利于提高ICU机械通气病人日常生活活动能力,降低ICU-AW、ICU获得性谵妄和下肢深静脉血栓发生率,缩短机械通气时间及ICU住院时间。

补阳还五汤联合利伐沙班治疗气虚血瘀型缺血性脑卒中后下肢深静脉血栓临床研究

目的:观察补阳还五汤联合利伐沙班治疗气虚血瘀型缺血性脑卒中后下肢深静脉血栓(LDVT)的疗效。方法:选取2022年7月—2023年6月温州市中西医结合医院收治的118例气虚血瘀型缺血性脑卒中后LDVT患者,按信封法随机分为对照组及观察组各59例。2组均接受现代医学常规治疗。对照组在常规治疗基础上加用利伐沙班治疗,观察组在常规治疗基础上加用补阳还五汤联合利伐沙班治疗,2组均治疗14 d。比较2组临床疗效,中医证候积分、美国国立卫生研究院脑卒中量表(NIHSS)评分、日常生活活动能力量表(Barthel)评分、Villalta评分和凝血指标[D-二聚体(D-D)、同型半胱氨酸(Hcy)、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]水平。结果:治疗14 d后,观察组临床疗效总有效率93.10%(54/58)高于对照组82.76%(48/58)(P<0.05)。治疗7 d、14 d后,2组中医证候积分均较治疗前降低,且观察组中医证候积分均低于同期对照组(P<0.05);治疗7 d、14 d后,2组NIHSS评分和Villalta评分均较治疗前降低,观察组NIHSS评分和Villalta评分均低于同期对照组(P<0.05);治疗14 d后,2组NIHSS评分和Villalta评分均低于治疗7 d后(P<0.05)。治疗7 d、14 d后,2组Barthel评分均较治疗前升高(P<0.05);治疗14 d后,2组Barthel评分均较治疗7 d后升高,观察组Barthel评分高于对照组(P<0.05)。治疗7 d、14 d后,2组D-D、Hcy、FIB水平均较治疗前降低(P<0.05);治疗14 d后,2组D-D、Hcy、FIB水平均较治疗7 d后降低(P<0.05)。治疗7 d、14 d后,2组PT、APTT、TT均较治疗前延长,观察组PT均长于同期对照组(P<0.05);治疗14 d后,2组PT、APTT、TT均较治疗7 d后延长(P<0.05)。2组均未出现不良反应。结论:补阳还五汤联合利伐沙班治疗气虚血瘀型缺血性脑卒中后LDVT可改善临床症状,降低D-Dimer及Hcy水平,有效改善凝血功能,发挥协同抗凝作用。

腔内介入技术用于下肢深静脉血栓形成的治疗进展

下肢深静脉血栓形成(DVT)是一种常见、具有致命性的临床疾病,可以导致下肢血液循环受阻,进而引发肢体坏死;血栓一旦脱落可能引发肺栓塞等严重后果。长期而言,可能会出现慢性并发症,如下肢静脉功能障碍和深静脉血栓后综合征,显著降低患者的生活质量。目前,该疾病的治疗依然具有挑战性。下肢深静脉血栓的常规治疗方法包括抗凝药物保守治疗和外科手术取栓。然而,随着介入手术技术的进步,多种介入方法已应用于DVT治疗,并展现出良好的疗效,使得目前治疗DVT更倾向于介入微创治疗。本文将从近些年临床上用于治疗下肢DVT的腔内介入手术方式逐一进行综述,旨在帮助提高DVT患者的治愈率及生存率。

以患者需求为导向的精细化护理干预在下肢深静脉血栓介入手术围手术期的应用价值

目的探讨分析以患者需求为导向的精细化护理干预在下肢深静脉血栓介入手术围手术期的应用价值。方法于2023年1月至2024年1月选取该院收治的下肢深静脉血栓介入手术患者79例,以随机数字表法分为2组,对照组(常规护理干预)39例和观察组(以患者需求为导向的精细化护理干预)40例,比较分析2组干预情况。结果干预后,与对照组比较,观察组患者依从性优良率高[97.50%(39/40)vs.82.05%(32/39)],并发症发生率低[2.50%(1/40)vs.20.51%(8/39)],世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分高,满意度高[95.00%(38/40)vs.76.92%(30/39)],差异均有统计学意义(P<0.05)。结论以患者需求为导向的精细化护理应用于下肢深静脉血栓介入手术围手术期有助于提高患者依从性,减少围手术期并发症,也能提高其生活质量及满意度。

补阳还五汤加减预防MIS-TLIF术后下肢静脉血栓临床研究

目的探究补阳还五汤加减预防微创经椎间孔入路腰椎椎间融合手术(MIS-TLIF)术后下肢静脉血栓的效果。方法病例选取符合纳入标准及排除标准的景德镇市中医医院骨伤科2021年12月—2023年11月间行MIS-TLIF手术患者60例,根据数字随机分组法分成治疗组、对照组,分别为30例。治疗组运用补阳还五汤加减结合那屈肝素钙口服进行预防;对照组通过那屈肝素钙进行预防;通过观察术后13 d、21 d日本骨科协会腰痛评分表(JOA评分)、D-2聚体、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)结果。评价补阳还五汤加减的临床疗效。结果两组患者术后13 dAPTT、PT、D-2聚体、JOA评分差异无统计学意义(P>0.05)。两组患者术后21 dAPTT、PT、D-2聚体、JOA评分差异有统计学意义(P<0.05),治疗组APTT、PT、JOA评分大于对照组,治疗组D-2聚体小于对照组。结论补阳还五汤加减通过改变机体抗凝机制,抑制血小板聚集,从而起到预防下肢静脉血栓的作用,同时恢复腰椎功能。