| ObjectiveA few domestic research has reported which the follow-up time is commonly early to mid and have not more detailed classification the research object,general model for the central or hybrid.It is longer follow-up period,more accurate classification.Evaluate the long-term venous cavity structure,PTS,quality of life with venous patency rate,CIVIQ-2 questionnaires,Villalta score.The data of 75 patients with lower extremity acute iliofemoral venous thrombosis is available in the vascular surgery of the second Affiliated hospital of guangzhou medical university between January 2012 and July 2016,divided into anticoagulant group(group A,34 cases),catheter thrombolysis with systemic anticoagulation group(group B,41cases),followed up for 3 ~ 63 months,to investigate long term efficacy analysis of anticoagulation,catheter directed thrombolysis(CDT)in the treatment of acute iliofemoral venous thrombosis and provide a better choice of treatmeat plan for patient with DVT.MethodsThe clinical data of 75 patients with lower extremity acute iliofemoral venous thrombosis in the vascular surgery of the second Affiliated hospital of guangzhou medical university between January 2012 and July 2016,divided into anticoagulant group(group A,34 cases),catheter thrombolysis with systemic anticoagulation group(group B,41 cases);Followed-up studies were performed to inquire about patientsymptoms,check the status of affected extremities and examine venous patency with venous ultrasonography or anterograde venous radiography.The incidence rate of post—thrombotic syndrome was evaluated with the Villalta score while the quality of life with CIVIQ-2 questionnaire.The patients were followed up for 3,6,12 months and yearly thereafter.etc.And the post,discharge anticoagulation time and use of compression stockings were analyzed in each group.Then,SPSS13.0 statistical software was used for statistical tests and made analysis and discussion finally.Results1、 The single center for follow-up were retrospectively analyzed 75 cases of acute iliac femoral venous thrombosis cases,catheter thrombolysis therapy joint anticoagulation group(group B)41 cases,systemic anticoagulant therapy group(group A)34 cases,following-up time was(26.03 + 19.99)months((range 3 ~ 63months),In the gender,age,physical distribution,basic diseases,have disease,etiology,duration of follow-up time,The differences both was insignificant between groups A and B(P>0.05).2、For group A venous patency score before treatment(7.29±2.86)and group B(8.54± 3.06),The differences both was insignificant between groups A and B(P >0.05).The patients were followed up for 3,6,12 months and yearly thereafter.etc.The differences both was significant between groups A and B(P<0.05).With patency score calculated corresponding to the two groups in patency rate,through statistical analysis,patency rate B group were higher than that of group A,The differences both was significant between groups A and B(P<0.05).3、Such remodeling effects as venous valvular destruction and intravenous wall thickening were observed in PTS patients with venous ultrasonography and anterograde venous radiography.The incidence of PTS was 52.94%(18/34)in groups A.,while B was 21.95%(9/41 during followed-up 3,6,12 months and yearly thereafter,the incidence of PTS differences between two groups was statistically significant(2 = 7.747,P = 7.747).the follow-up of 60 months in group A PTS occurence rate is about 52.7%,group B is about 30%,the incidence of PTSdifferences between two groups was statistically significant(the Log Rank test: 2 =3.922,P = 0.048).4、(26.03 + 19.99)months,an average follow-up treatment after 3,6,12,24,36,48,60 months follow-up,CIVIQ-2 questionnaire score statistics,CIVIQ-2 score lower than group A,group B was statistically significant difference between the two groups(P < 0.05);Similarly,Villalta,score statistics and analysis,Villalta score lower than group A,group B was statistically significant difference between the two groups(P < 0.05);5、The differences of average anticoagulant time and compression stocking use were insignificant in 2 groups(P>0.05).ConclusionThe treatment of Catheter-directed thrombolysis has significant role in improving the vein patency in patients with DVT.Compared with anticoagulant,a combination of CDT and anticoagulation may reduce the risk for PTS and may improve quality of life in the long-term clinical effect. |
