Hydration Treatment In Angiojet Thrombus Aspiration Preventive Effect On AKI

BackgroundLower extremity deep venous thrombosis(LEDVT)is a common disease in vascular surgery,accounting for 40%of peripheral vascular disease clinics,and the global incidence rate is about 1 ‰,and it is increasing year by year.If the LEDVT is not effectively treated in the acute phase,thrombosis may spread or fall off,and pulmonary embolism(PE)is more likely to occur,which is fatal and severely disabling;if the thrombosis enters the chronic stage,it may be Post-thrombotic syndrome(PTS)occurs a few months later,resulting in swelling,pigmentation,skin sclerosis,and repeated ulcers of the affected limb,which seriously affects the patient's normal quality of life.In addition to traditional anticoagulation and thrombolytic therapy,the current clinical treatment of acute proximal LEDVT is mainly catheter-directed thrombolysis(CDT)and mechanical thrombectomy(percutaneous mechanical throlnbectomy,PMT).Among them,Angiojet thrombus aspiration device is a representative method of PMT,which has the advantages of fast thrombectomy speed,high removal efficiency,reduced bleeding risk,and wide application range.Now,it has been more and more widely used in clinical.However,cell debris and hemolysis products produced during thrombus aspiration also increase the risk of acute kidney injury(AKI).Hydration treatment refers to a method of increasing the blood flow of the kidney through fluid replacement,accelerating the excretion of toxic substances,and reducing the retention of toxic substances in the kidney.Hydration therapy is currently recognized as the most effective measure to prevent contrast agent nephropathy.However,in the PMT procedure,there is currently no standardized perioperative management plan.The most commonly used clinical practice is empirical prevention.What is the effect of hydration treatment in the PMT procedure?At present,there are few studies in this area.purposeTo analyze the effect of intravenous hydration on renal function in the operation of Angiojet thrombectomy device for patients with acute lower limb deep vein thrombosis(LEDVT),to study the prevention of acute kidney injury by intravenous hydration treatment in this operation(AKI)provides a more complete and standardized treatment plan for the prevention of perioperative complications in patients with thrombectomy.methodsCollected clinical data of 74 patients with acute lower extremity deep vein thrombosis treated with Angiojet thrombus aspiration from December 2016 to April 2019 in the First Affiliated Hospital of Zhengzhou University and performed retrospective analysis,according to the different treatment methods Hydration treatment group(experimental group)and conventional treatment group(control group).Chi-square test,Fisher's exact probability method,independent sample t test and other statistical methods were used to analyze the effect and relationship of the presence or absence of hydration treatment on renal function changes.results1.1.In this study,there was no statistically significant difference in the general conditions of preoperative blood creatinine,glomerular filtration rate,gender,age,whether diabetes and hypertension among the two groups of patients(P>0.05).2.The results of two independent samples t test showed that compared with the control group,the experimental group had statistically significant difference in the changes of blood creatinine and glomerular filtration rate before and 48 hours after operation(P<0.05).AKI1(3%)cases occurred in the experimental group after operation,and AKI11(29%)cases occurred in the control group.There was a statistically significant difference in the incidence of postoperative AKI between the two groups(P<0.05).The difference in treatment efficiency between the two groups was statistically significant(P<0.05).3.Chi-square test analysis showed that:There were 30 cases(88%)of postoperative hemoglobinuria in the experimental group and 37 cases(97%)of gross hematuria in the control group.There was no statistically significant difference in the incidence of total bleeding between the two groups(P>0.05).No acute heart failure occurred in the two groups,and there was no statistical difference.ConclusionIn the process of using Angiojet thrombectomy device to treat acute stage LEDVT,compared with the control group,the experimental group can effectively control the changes of postoperative blood creatinine and glomerular filtration rate,and the probability of AKI is significantly reduced.Compared with the control group,the incidence of adverse events was not increased,indicating that hydration therapy is a safe and effective treatment for preventing AKI in this procedure.