Effect of cathter-directed thrombolysis combined with intermittent pulsed anticoagulation in the treatment of acute deep venous thrombosis of the lower extremity

Objective:To explore the effects of cathter-directed thrombolysis combined with intermittent pulsed anticoagulation in the treatment of acute deep venous thrombosis(DVT) of the lower extremity.Methods:The clinical data of 37 patients with lower extremity DVT were retrospectively analyzed.The patients were divided into the observation group and control group according to the use of urokinase.The observation group was injected with 48 mL of 0.9% saline injection containing 100 000 units of urokinase,4 to 8 mL/h,for 24 h,and treated additionally with low concentration of heparin pulsed flush thrombolytic catheter,2 to 3 times a day.The control group was injected within 30 min,and the heparin solution and dexamethasone were not used.Results:After 1 and 2 weeks of treatment,the remission degree of lower limb swelling in observation group was better than that in control group(P<0.01 and P<0.05).After 2 weeks of treatment,the remission degree of swelling and pain in two groups,and venous patency in observation group were significantly better than those after 1 week of treatment(P<0.01).After treatment,the arterial partial pressure of oxygen and international normalized ratio in two groups were significantly improved,and the arterial partial pressure of oxygen in observation group was higher than that in control group(P<0.01).The effective rate of treatment in observation group and control group were 65.00% and 35.29%,respectively,and the difference of which was not statistically significant(P>0.05).Among 37 patients,32 cases were followed up for 90 to 360 d,1 case with slight swelling in observation group and 4 cases with moderate swelling in control group were found.Doppler color ultrasound or lower extremity deep venography examination showed that the part of valve was damaged,and the thrombosis in femoral vein and popliteal vein remained or recurred.Conclusions:The cathter-directed thrombolysis combined with intermittent pulsed anticoagulation can relieve the swelling of lower extremity DVT,improve the venous patency,and reduce the survival and recurrence of thrombus.