Effect Of Nursing Intervention To Catheter Directed Thrombolysis On Acute Ischemic Disease Of Lower Extremities

Objective:To study the effect of nursing intervention on acute ischemic disease of lower extremities by Catheter Directed Thrombolysis(CDT).Methods:66cases with acute ischemic disease of lower extremities were investigated from2011to2013in Tianjin Medical University General Hospital (The course was less than3days). Thrombetomy and Catheter directed thrombolysis had been performed to32cases and34cases individually with the consent of family members of patients. Anticoagulation therapy was the following therapy after thrombetomy. Thrombolytic medicine and correlated nursing intervention were given to the patients with CDT. Postoperative symptom remission rate, limb salvage rate, mortality rate, reperfusion injury rate (including renal inadequacy rate, heart failure rate, muscle fascia compartment syndrome rate), bleeding rate, and limb dysfunction rate of the patients above was be collected and the comparation of the curative effect and complication rate between the2groups was performed. The important role of nursing intervention in ensuring the safety and effectiveness of the thrombolytic therapy was observed.Results:There was no significant differences on the rate of symptom remission, limb salvage, motality, bleeding rate and limb dysfunction rate between2groups. Within the thrombetomy group and Catheter directed thrombolysis group, symptom remission rate was93.75%and94.11%respectively; limb salvage rate was96.88%and100%respectively; motality rate was3.13%and0respectively; bleeding rate was0%and8.82%respectively; limb dysfunction rate was0%and5.88%respectively. The incidence of reperfusion injury was higher in the group of thrombectomy (p<0.05). Within the Thrombetomy group and Catheter directed thrombolysis group, renal inadequacy rate was21.88%and2.94%respectively, Catheter directed thrombolysis group is better (p<0.05); heart failure rate was9.38%and0%,no significant differences (p>0.05); muscle fascia compartment syndrome rate was6.25%and0%,no significant differences (p>0.05).Conclusion:Similar effect of treatment and less reperfusion injury had been achieved by CDT compared with thrombetomy. Nuring intervention, especially the regulating and controlling of microscale injecting pump, the observation of extremity and the psychological nursing care is very important to decrease incidences of bleeding and reperfusion injury during CDT.