Clinical Research Of Catheter-Directed Thrombolysis On Acute Lower Extremity Deep Venous Thrombosis

Purpose:Retrospectively analyze the clinical effects of catheter-directed thrombolysis(CDT)in the treatment of acute and subacute deep venous thrombosis of lower extremity(LEDVT)and the effects of urokinase and recombinant tissue type fibrinogen activator(rt-PA)in acute deep venous blood of lower extremity.Clinical effect of thrombolytic therapy for thrombosis formation.Methods: clinical data of patients with acute and subacute LEDVT treated by CDT in the department of vascular surgery of the first affiliated hospital of guangxi medical university from January 2015 to January 2018 were collected to retrospectively analyze the clinical effect of CDT in its treatment.Set up the experimental group of surgical methods and thrombolytic drugs.The short-term efficacy,mid-term efficacy and safety of CDT treatment alone and CDT+PTA in acute and subacute LEDVT patients in the experimental group were compared.The short-term efficacy,mid-term efficacy and safety of thrombolytic therapy in patients with urokinase alone and urokinase + rt-pa in the experimental group.Results:1.165 of the 191 patients were followed up after surgery,and 26 were lost to follow-up,with a follow-up rate of 86.39%.2.Operation method in the experimental group: compared with the acute CDT+PTA treatment group,the short-term and mid-term postoperative efficacy of patients in the acute CDT+PTA treatment group was similar,and there was no statistically significant difference in the evaluation indexes(P > 0.05).There was no significant difference in short-term efficacy between subacute CDT group and subacute CDT+PTA group(P > 0.05).The Villalta score of CDT+PTA group was lower than that of CDT group,and the difference was statistically significant(P < 0.05).3.Thrombolytic drugs in the experimental group: compared with the urokinase+Rt-pa thrombolytic group,there was no statistically significant difference in the evaluation indexes of short-term and mid-term efficacy(P > 0.05).4.In the comparison of safety,the incidence of complications between the experimental group of surgical methods and the experimental group of thrombolytic drugs were similar,and the difference was not statistically significant(P>0.05).However,thrombolytic time was shorter in the urokinase + rt-pa thrombolytic group,and the difference was statistically significant(P < 0.05).Conclusion:1.In patients with acute LEDVT,there was no significant difference in the short-term and mid-term efficacy between the two treatment methods of CDT alone and CDT+PTA.2.In patients with subacute LEDVT,the mid-term efficacy of CDT+PTA is better than that of CDT alone.3.The safety of CDT treatment and CDT+PTA treatment were similar.4.In patients with acute LEDVT,urokinase + rt-pa thrombolysis can significantly reduce thrombolytic time,with better thrombolytic efficiency and no increased risk of complications such as bleeding.