The Clinical Research Of Thrombolytic Therapy To Prevent Post-thrombotic Syndrome

Background:The Lower extremity deep venous thrombosis (DVT) is a common disease in vascular disease, with high morbidity and mortality, only a small number of patients can be cured, most patients will develop post-thrombotic syndrome (PTS). Post-thrombotic syndrome is a severe complication of lower extremity deep vein thrombosis, scholars have reported that about20%to50%of patients developed PTS within two years, of which about5%to10%of patients will develop venous ulcer and it is serious impact on the quality of life of the patients, and bring great inconvenience and pain to patients,so the active treatment and prevention is the key to treatment of post-thrombotic syndromePurpose:The purpose of this study is to analysis and study the function of thrombolytic therapy to prevent the post-thrombotic syndrome, according to the Villalta score.Method:According to the principle of randomized control, Patients aged of18-75years in our hospital from January of2008to July of2010will be recruited, they are all onset of symptoms in21days. Respectively received conventional therapy alone (group A) and additional thrombolytic therapy (group B). Group A was treated with anticoagulation and promoting blood circulation therapy, group B received thrombolytic therapy on the basis of group A, assessed incidence and severity of PTS by24months Villalta score. This group included70cases of acute lower extremity deep vein thrombosis,The number of group A is28, group B is42, The patients of group B were all placed inferior vena cava filter and thrombolysis.Results:All of the70patients after treatment, the symptoms before and after treatment were obviously improved,The ipsilateral limb circumference (including middle thigh and calf middle) of group A and B group before and after treatment showed significant difference (P<0.05). The effect of group B was more obvious than group A, with significant difference (P<0.05)The prior treatment score of venous patency:Group A9.08±1.38, Group B9.23±1.33;without significant difference(P>0.05). The post treatment score of venous patency:Group A5.17±1.24, Group B3.68±0.98; with significant difference(P<0.05). The score of venous patency of Group B was much smaller than those of Group A has significant difference(P<O.05). Of the70patients, In24months a total of53patients completed the follow-up,21cases in group A,32cases in group B, according to the results by Villalta score, occurrence of thrombosis syndrome:group A,13normal persons,4mild (5-9), moderate in3(10-14), severe1(>15or ulcer). Group B:23normal persons, mild in6, moderate in3, severe in0.Conclusion:The Villalta score can evaluate the post-thrombotic syndrome from the objective and subjective, and it is a better post-thrombotic syndrome assessment tool.