| Objective:To evalute the security and clinical efficacy of two-way catheter-dirceted thrombosis in patients with deep venous thrombosis of lower extremity,by the observation and analysis of the clinical efficacy of cases who were treated with this method.Materials and Methods:37patients (37limbs), who were diagnosed acute deep venous thrombosis of lower extremity were collected from october2010to february2013and were randomly divided into group A and group B. The patients in group A (18patients) were placed antegrade and retrograde double-way central venous catheter; while the patients in group B (19patients) were placed single-way catheter. Inferior vena cava filter were implanted to all patients in both groups. Statistical data of patients in two groups, including the total effective rate, the limbs edema reduction rate, the venous patency, the thrombolytic days and the dose of urokinase,were collected. Then t-test was made to these data. The follow-up was staken at1,3,6,12and24months after the treatment.Results:1. The technical success rate of both groups were100%. The total effective rate of group A was94.4%. The total effective rate of group B was94.7%;2. The lower extremity edema of patients in both groups alleviated in different degrees. In group A, the difference of circumference between the affected limb and the contralateral limb were (6.44±0.97)cm and (0.92±0.81)cm before and after treatment. And the limb edema reduction rate was (86.03±10.73)%. The difference of circumference between preoperative and postoperative was statistically significant (P=0.00). In group B, the difference of circumference between the affected limb and the contralateral limb were (6.41±0.88)cm and (1.02±0.76)cm before and after treatment. And the limbs edema reduction rate were (84.43±10.41)%. The difference of circumference between preoperative and postoperative was statistically significant (P=0.00). The difference of the limb edema reduction rate between the two groups were not statistically significant (P=0.648); 3. The lower extremity venous patency of patients in both groups was improved in different degree. In group A, the venous patency score of patients was (5.06±1.11) and (2.11±1.32) before and after treatment. The venous patency was (61.26±19.67)%. In group B,the venous patency score of patients was (5.11+1.20) and (2.21±1.03) before and after treatment respectively. And the venous patency were (58.21±15.62)%. The difference of the venous patency between the two groups was not statistically significant (P=0.604);4. The thrombolysis duration and the dose of urokinase of patients in the two groups were different. The thrombolytic duration of group A was (5.44±1.46) days, the thrombolytic duration of group B was (6.84±1.43) days. The difference of the thrombolytic duration between the two groups were statistically significant (P0.006). The dose of urokinase was (217.78±58.57) million U in group A and (273.68±56.98) million U in group B. The difference of the dose of urokinase between the two groups was statistically significant (P=0.006);5. Complications after operation. Subcutaneous hematoma in the puncture point of uninjured side occurred in1patient of group A and1patient in group B.5cases had hematoma and ecchymosis around the puncture point. The complication occurrence rate in group A was lower than it in group B (P<0.05). The patients in group A felt more comfortable than the patients in group B during the treatment.Conclusion:1. Two-way catheter-directed thrombolysis in the treatment of deep venous thrombosis formation was a method with a high technical success rate, fewer complications occurrence and better security.2. The clinical curative effect of two-way catheter-directed thrombolysis was obvious. Compared with conventional CDT, this new method reduces thrombolytic duration and the dose of urokinase.What’s more, the comfort level of patients was higher by this treatment. |
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