J Vis Exp. 2026 Oct 16;(236). doi: 10.3791/72100.
ABSTRACT
Postoperative lower limb deep vein thrombosis (DVT) remains a common complication after hip fracture surgery, and complementary strategies targeting coagulation, inflammation, and venous circulation may provide additional preventive benefits. This retrospective cohort study included 86 patients who underwent hip fracture surgery between June 2023 and June 2024. Patients were assigned to a control group (n = 43), receiving standard low-molecular-weight heparin (LMWH) prophylaxis, or an observation group (n = 43), receiving additional Taohong Siwu Decoction-based targeted drug penetration therapy. The primary outcome was postoperative lower limb DVT within 10 days after surgery. Secondary outcomes included coagulation parameters, inflammatory markers, femoral venous blood flow velocities, postoperative pain, limb swelling, and treatment-related adverse events. DVT occurred in 1/43 patients (2.33%) in the observation group and 10/43 patients (23.26%) in the control group (Fisher's exact P = 0.007). In a parsimonious Firth penalized logistic regression model adjusting for age and baseline D-dimer, adjunctive therapy remained associated with a lower likelihood of postoperative DVT (adjusted odds ratio [OR] = 0.12, 95% confidence interval [CI]: 0.02-0.68, P = 0.017). After 10 days of treatment, the observation group had lower Faces Pain Scale-Revised scores and limb swelling, longer activated partial thromboplastin time and prothrombin time, lower D-dimer levels, higher common and superficial femoral vein blood flow velocities, and lower serum tumor necrosis factor-alpha and interleukin-6 levels than the control group (all P < 0.05). No statistically significant between-group difference was observed in overall adverse-event occurrence, and no severe treatment-related adverse events were recorded. Taohong Siwu Decoction-based targeted drug penetration therapy combined with standard anticoagulation was associated with a lower incidence of early postoperative DVT and favorable differences in coagulation, inflammatory, and venous hemodynamic parameters.
PMID:42891604 | DOI:10.3791/72100