Comparative Study On Thrombolytic Threapy Through Different CDT Infusion Modes Combined With Administration Methods By Superficial Dorsal Pedal Vein For Acute Left Lower Extremity Mixed DVT

Objective:To evaluate the effects of three CDT infusion modes combined with administration methods by dorsal foot vein on thrombolytic efficacy and incidence of complications of thrombolytic therapy in patients with acute left lower extremity mixed DVT.Methods:Retrospectively analysised patients of acute left lower limb mixed DVT who were treated by indwelling thrombolytic catheter through contralateral femoral vein approach.Depending on three infusion modes of thrombolysis drug through CDT,cases were divided into three group.Group A:patients received CDT with continuous pumping infusion simultaneously combined with administration methods by dorsal foot vein,Group B:patients received CDT with intermittent pulse-spray infusion simultaneously combined with administration methods by dorsal foot vein,Group C:patients received CDT with intermittent pulse-spray infusion,fellowed continuous pumping infusion,simultaneously combined with administration methods by dorsal foot vein.According to patients with lower limb vein angiography image points Marder score before and after thrombolysis treatment,to score value calculation in patients with venous patency rate and compare the difference between the three groups,the second line respectively between the three groups of patients with iliac femoral,popliteal and had three sections of venous patency rate of subgroup analysis,further within each group of each subgroup analysis of venous leg vein patency rate.Finally,limbs edema reduction rate,auxiliary stent implantation rate,total days of thrombolysis,incidence of catheter-related bloodstream infection during CDT indwelling,and incidence of FIB<1g/L were compared among the three groups to evaluate the impact of three different drug delivery modes on thrombolytic effect and incidence of complications.Results:A total of 162 patients were included.The vein patency rates of group A(42),B(54)and C(66)were(49.72±2.90)%,(66.11±1.83)%,(83.15±1.51)%,respectively.The limbs edema reduction rate were:(48.84±2.15)%,(62.50±2.12)%,(76.51±1.80)%;The total days of thrombolysis were 10.00(8.00,12.25),9.00(6.75,11.00)and 6.00(4.00,7.00)days,respectively.The vein patency rate and limbs edema reduction rate in group C were higher than those in group A and B(P<0.001),and the total thrombolysis days in group C were lower than those in group A and B(P<0.001).There was no statistical significance in the rate of assisted stent implantation and the incidence of complications among the three groups(ALL P>0.05).Subgroup analysis of vein patency rate of each vein segment among the three groups were all(P<0.001),and subgroup analysis of vein patency rate of each vein segment within the three groups were all(P<0.001).Conclusion:The intermittent pulse-spray infusion followed by continuous pumping infusion simultaneously combined with administration methods by dorsal foot vein mode may be the preferable treatment of acute left lower extremity mixed DVT,alone in the treatment of normative nursing measures can effectively prevent the happening of the complications such as infection,bleeding.