Clinical Analysis Of The Treatment Efficacy Of Cockett Syndrome With Acute Thrombosis

Objective:To investigate the curative effect of different treatment methods of Cockett syndrome combined with acute deep vein thrombosis(DVT)and whether routine treatment of CDT was performed,and to find a more reasonable treatment for Cockett syndrome with acute DVT.Methods:Retrospective analysis the first affiliated hospital of Zhengzhou University in August 2014 to April 2016 during the treatment of 89 cases of Cockett syndrome combine with acute lower limb DVT patients.The patients were divided into experimental group(group A and group B)and control group(group C),Group A of 36 patients conduct Inferior vena cava filter implantation and catheterization thrombolysis,for the first ball expansion;B group of 22 patients conduct catheter-directed thrombolysis,do not perform first ball expansion;group C of 31 patients with limb foot dorsal vein pumped thrombolytic drugs for treatment;three groups are assisted anticoagulation,blood circulation,swelling drugs and wear elastic stockings and other treatment,comparion of group A and B patients with thrombosis degree,the incidence pulmonary embolism assessment the therapeutic treatment,All patients were treated with warfarin for at least 6 months.Long-term were followe-up by telephone,review the color doppler ultrasound or deep vein anteroposterior angiography,the therapeutic treatment and the incidence of thrombosis-related events were observed by venous clinical severity score and efficacy rating Results:During the treatment period,the success rate of group A and B was 100%,and no pulmonary embolism,the difference was not statistically significant(P> 0.05),no disease-related death cases,3 cases of gingival bleeding,epistaxis,hematuria adjustment program symptoms disappeared.compared group A and B of thrombolytic therapy on the third day(Hc=6.646,P=0.01),there are statistical differenceces(P <0.05),The thrombolytic therapy on the seventh day(Hc=2.186,P=0.139),the difference was no statistical significant(P>0.05).group A 11 cases of ball expansion,16 cases of stent placement;group B 7 cases of ball expansion,11 cases of stent placement.87 cases were followed up for 3-20 months,with an average 8.9 months,2 cases of thrombosis recurrence in the stent,the efficiency of group A and group B were 100%,comparing the thrombolytic therapy between groups(Hc=0.079,P=0.778),there were no statistical significant(P>0.05);the efficiency of group C was 80%,comparing the curative effect between experimental group and control group(Hc=13.026,P=0.000),the difference had statistical significant(P<0.05).The incidence of post-thrombotic syndrome,the experimental group lower than the control group,the difference had statistically significant(P<0.05).comparing of the VCSS scores between the three treatment(χ2=50.226,P=0.000),the difference had statistically significant(P<0.05).compared group A with group C(Z=6.572,P=0.000)and group B with group C(Z=5.311,P=0.000),the difference had statistically significant(P<0.05),but compare group A and group B(Z=0.541,P=0.295),there were no significant difference between(P> 0.05).Conclusion:1.For Cockett syndrome with acute thrombosis treatment,endovascular treatment and treatment of drug thrombolytic effect is better,and has a fast onset,trauma,fast recovery,patency rate is high,the incidence of thrombosis after the low rate of syndrome;2.For the Cockett syndrome with acute thrombosis for CDT treatment,the experimental results show that the incidence of pulmonary embolism had no difference,our center thinks can not be placed in the inferior vena cava filter;3.CDT treatment at the same time,the first balloon dilatation and no balloon dilatation comparison,thrombolytic effect after the short 3d difference,the first 7d difference is not obvious,indicating that the first balloon can reduce the amount of thrombolytic drugs to reduce bleeding Complications occurred,but no significant difference in long-term treatment.