Evaluation Of Anticoagulant Effect Of Acute Isolated Distal Deep Venous Thrombosis By Color Doppler Ultrasound

Objective To investigate the efficacy and safety of rivaroxaban and warfarin in treatment of acute isolated distal deep vein thrombosis(IDDVT).Methods A total of 103 patients with acute isolated distal deep vein thrombosis were studied.The patients were randomly divided into 2 groups:55 cases were treated with oral warfarin,and were initial treated with low molecular weight heparin,the initial dose was 3mg/d,and the INR values were daily monitored,and low molecular weight heparin was disable when the INR values were stable in 2.0-3.0,but oral warfarin continued to use and the INR values were monitored every 3-4 days,and the dosage was adjusted to maintain INR values between 2.0-3.0.Then the INR was monitored every 1 weeks,and continue to monitored every 2 weeks;48 cases was classified to rivaroxaban group,and 15mg rivaroxaban tablets were oral given for Bid and continued for 3 weeks,then 20mg rivaroxaban tablets were oral given for qd.All patients were followed up for 3 months,change of the thrombosis,blood flow of lower etremity vein,complete recanalization time of the thrombus,the number of complete recanalization and partial recanalization of venous thrombosis,the recurrence rate of thromboembolism,pulmonary embolism and bleeding events during treatment period,any cause drug withdrawal events were compared between 2 groups,when treating 14,30,60,90 days.Results With the prolongation of treatment time,the size of venous thrombus gradually decreased,the echo was enhanced and uneven.38 cases of embolism vein completely recanalization and 39 cases of partial recanalization of embolized vein,a little narrow stripe blood flow signal can be seen in embolized vein.The efficacy of rivaroxaban and warfarin in treatment of acute isolated distal deep vein thromboembolism was significant,but rivaroxaban group had the shorter thrombus remission time[(41.90±15.67d)vs(48.56±17.64d),P>0.05].The recurrence rate of thromboembolism and pulmonary embolism were similar between 2 groups(P>0.05).But warfarin group had slightly higher bleeding events and drug withdrawal events(P<0.05).Conclusions Ultrasound has a high clinical value in evaluating the therapeutic effect of acute distal deep venous thrombosis,which is worth popularizing.At the same time,the efficacy rivaroxaban and warfarin in treatment of acute isolated distal deep vein thromboembolism has no obvious difference,rivaroxaban is an effective and safe alternative to warfarin in patients with isolated distal deep vein thromboembolism,can mminimise the need for laboratory monitoring of the anticoagulant effect and frequent dose adjustments,which had more secure and convenient especially for outpatient patients.