Analysis Of Anticoagulant Compliance And Clinical Efficacy In Patients With Deep Venous Thrombosis

Deep venous thrombosis(DVT)is a common disease in vascular surgery,and the incidence rate is increasing year by year.Lower extremity deep venous thrombosis is the most common disease in clinic.Long-term anticoagulation is the basic treatment of DVT.Warfarin is the main drug used clinically at present.Because of its vulnerability to age,diet,drug interactions,individual differences and other factors,it is necessary to monitor the International Standardized Ratio(INR)regularly.Considering various factors,the anticoagulation compliance of DVT patients after discharge may be different.In this paper,through a 12-month follow-up survey of 200 DVT patients,we studied and analyzed their anticoagulation compliance and clinical efficacy,and explored whether anticoagulation compliance had an impact on their clinical efficacy.Objective:Follow-up analysis of patients with deep venous thrombosis(DVT)anticoagulation compliance,comparison of vascular patency after anticoagulant therapy in patients with different compliance,cumulative statistics of the incidence of bleeding and lower extremity deep venous thrombosis syndrome(PTS)incidence,compare the differences between patients with different compliance,and then explore whether anticoagulation compliance of DVT patients has an impact on its clinical efficacy.Methods:Two hundred patients admitted to our hospital from September 2016 to January 2018 and diagnosed as DVT.After discharge,200 patients needed oral warfarin maintenance therapy.General data of subjects(gender,age,affected limb location,DVT type)were collected,and follow-up records of patients were designed.Three months later,the subjects were followed up according to Morisky's drug compliance questionnaire,INR review times and standard rate,and color Doppler ultrasound results.The subjects were grouped according to their compliance.They were divided into good compliance group and poor compliance group.The venous patency rate between the two groups was also compared and analyzed.After 12 months,the patients were followed up according to the symptoms and signs of the Villalta scale,the time of re-visit,the results of color Doppler ultrasound and the related tables with or without bleeding.The incidence of bleeding and PTS were counted.The diagnostic criteria of DVT and PTS refer to the latest Chinese edition of the Guidelines for the Diagnosis and Treatment of Deep Venous Thrombosis.Results:1?Grouping of subjects for follow-up 3 months after discharge:There were 72 cases in the group with good compliance,38 males and 34 females;the average age was(62.03 +4.98)years old;38 cases in the central type,34 cases in the mixed type,40 cases in the left lower limb,27 cases in the right lower limb and 5 cases in the bilateral lower limbs.There were 128 cases in the poor compliance group,62 males and 66 females;the average age was(63.40 + 5.08)years old;61 cases in the central type,67 cases in the mixed type,73 cases in the left lower limb,49 cases in the right lower limb and 6 cases in the double lower limbs.There was no significant difference in gender,age and DVT type between the two groups(P > 0.05),which was comparable.2?Review of Doppler ultrasonography three months after discharge:In the group with good compliance,46 cases were completely unobstructed,24 cases were partially unobstructed and 2 cases were completely unobstructed.The venous patency rate was 97.22%.In the poor compliance group,30 cases were completely unobstructed,86 cases were partially unobstructed and 12 cases were completely unobstructed.The venous patency rate was 90.63%.There was significant difference between the two groups(P < 0.05).3 ? Villata score 12 months after discharge: Villata score in good compliance group(3.32 +2.89)was lower than that in poor compliance group(4.88 +4.45),and there was a significant difference between the two groups(P < 0.05).4?Incidence of PTS 12 months after discharge: 193 cases were followed up after 12 months,including 69 cases in the good compliance group and 124 cases in the poor compliance group.During the follow-up,7 cases were lost(3 cases in the good compliance group and 4 cases in the poor compliance group),4 cases died,1 case of tumors and 2 cases of other causes;21 cases were discontinued due to bleeding complications(3 cases in the good compliance group and 18 cases in the poor compliance group).)The incidence of PTS in good compliance group(24.24%)was lower than that in poor compliance group(41.51%).There was a significant difference between the two groups(P < 0.05).5?The incidence of hemorrhage: The incidence of hemorrhage in the good compliance group(4.2%)was lower than that in the poor compliance group(14.1%).There was a significant difference between the two groups(P < 0.05).6 ? Anticoagulant compliance: MMAS-8 score in PTS group was significantly lower than that in non-PTS group,and the difference between the two groups was statistically significant(P < 0.05).The level of INR in PTS group was significantly lower than that in non-PTS group,and there was a significant difference between the two groups(P < 0.05).Conclusion:1.The anticoagulation compliance of patients with deep venous thrombosis affects the clinical efficacy to a certain extent.2.Improving the anticoagulation compliance of patients with deep venous thrombosis can effectively improve the venous patency rate and reduce the incidence and severity of post-thrombotic syndrome,and improve the effectiveness of anticoagulation therapy.3.Improving the anticoagulation compliance of patients with deep venous thrombosis can effectively reduce the occurrence of bleeding events and improve the safety of anticoagulation therapy outside the hospital.