关键词: 关节成形术, 骨折, 气滞血瘀证, 深静脉血栓, 灸法, 中医护理学

Abstract:

Objective To investigate the effect of Xiaoyu Tongluo fumigation moxibustion on the prevention of lower extremity DVT in patients with qi stagnation and blood stasis syndrome after major orthopedic surgery. Methods On the basis of literature review and expert meeting discussion，the intervention plan was constructed. A total of 132 patients with qi stagnation and blood stasis syndrome after major orthopedic surgery who were hospitalized in the joint department of an orthopedic hospital in Zhejiang Province from November 2021 to November 2022 were selected as the research subjects by stratified sampling method. They were divided into a Xiaoyu Tongluo fumigation moxibustion group，a moxibustion group and a control group，with 44 cases in each group. On the basis of the control group，the moxibustion group was treated with Xiaoyu Tongluo fumigation moxibustion；the moxibustion group was treated with moxibustion on the basis of the interventions in the control group，and the control group was given routine nursing measures to prevent the formation of DVT. The incidence of lower extremity DVT before discharge，coagulation function indexes on the 1st and 7th day after operation and daily pain score were compared among the 3 groups，and the intervention effect was evaluated. At the same time，the safety and feasibility of the intervention program were evaluated by the occurrence and completion rate of adverse reactions. Results There was no lower extremity DVT in the Xiaoyu Tongluo fumigation moxibustion group. The incidence of lower extremity DVT was 4.65 % in the moxibustion group and 16.67 % in the control group. The difference in the incidence of lower extremity DVT between the Xiaoyu Tongluo fumigation moxibustion group and the control group was statistically significant（P<0.05）. Before and after the intervention，there were statistically significant differences in D-dimer，activated partial thromboplastin time，fibrinogen and prothrombin time among the 3 groups（P<0.05）. After the intervention，there were significant differences in D-dimer，activated partial thromboplastin time，fibrinogen and prothrombin time among the 3 groups（F=41.885，P<0.001；F=247.377，P<0.001；F=32.626，P<0.001；F=17.056，P<0.001）. The pain scores of the 3 groups were statistically significant on the 6th and 7th day after operation（P<0.05）. There was no adverse reaction during the intervention period in the moxibustion group and the moxibustion group，and the completion rate was 97.73%. Conclusion Compared with moxibustion， Xiaoyu Tongluo fumigating moxibustion can more effectively reduce the incidence of DVT in lower limbs of patients with qi stagnation and blood stasis syndrome after major orthopedic surgery，effectively improve the hypercoagulable state of patients，and continuously relieve the pain of affected limbs. The intervention program has good safety and feasibility.

Key words: Arthroplasty, Fracture, Qi Stagnation and Blood Stasis Syndrome, Deep Vein Thrombosis, Moxibustion, Traditional Chinese Medicine Nursing