Effect of transcutaneous electrical acupoint stimulation combined with acupoint-injection of lappaconitine on deep venous thrombosis after total knee arthroplasty
MENG Xiao-qun,JI Jia-fu,ZHANG Wei-liang
Department of Anesthesiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine，Jinan250014，China
Abstract:
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 who underwent total knee replacement surgery in the orthopedics Department of the Affiliated Hospital of Shandong University of Chinese Medicine from January 2021 to January 2022 were randomly divided into TEAS combined with acupoint injection group (group S), TEAS group (group T) and control group (group D), 30 cases each.The 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 ,including preoperative prothrombin time(PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and d-dimer (D-dimer) .Collect three groups of patients with venous blood samples to test the cortisol(COR) and adrenocorticotropic hormone(ACTH) levels in after anesthesia before surgery, postoperative immediately,24 hours after surgery. Results 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. There was no significant difference in PT, APTT, FIB and 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 day 3 and 7 after surgery (P>0.05). There was no statistically significant difference in COR and 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). There was no significant difference in the incidence of postoperative DVT among the three groups (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.
