Volume 21 Issue 4
Apr.  2023
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WANG Ying, WANG Xiaogao, GUAN Zeyu, Ayoade Philip Adegoke, GAO Yong, YU Chaowen, CHEN Shiyuan, LU Ran. Application of low molecular weight heparin combined with unfractionated heparin in direct thrombolysis of lower extremity deep vein thrombosis[J]. Chinese Journal of General Practice, 2023, 21(4): 568-571. doi: 10.16766/j.cnki.issn.1674-4152.002932
Citation: WANG Ying, WANG Xiaogao, GUAN Zeyu, Ayoade Philip Adegoke, GAO Yong, YU Chaowen, CHEN Shiyuan, LU Ran. Application of low molecular weight heparin combined with unfractionated heparin in direct thrombolysis of lower extremity deep vein thrombosis[J]. Chinese Journal of General Practice, 2023, 21(4): 568-571. doi: 10.16766/j.cnki.issn.1674-4152.002932

Application of low molecular weight heparin combined with unfractionated heparin in direct thrombolysis of lower extremity deep vein thrombosis

doi: 10.16766/j.cnki.issn.1674-4152.002932
Funds:

 KJ2019A0327

 201904a07020020

 AHWJ2021a016

 2020fyjyxm14

 2020byzd67

 20200343

  • Received Date: 2022-02-23
    Available Online: 2023-05-31
  •   Objective  To explore the clinical efficacy of different anticoagulation regimens during catheter-directed thrombectomy (CDT) in deep venous thrombosis (DVT) of the lower extremities.  Methods  A total of 35 DVT patients admitted to the Department of Vascular Surgery of the First Affiliated Hospital of Bengbu Medical College Hospital from March 2021 to February 2022 were selected.They were randomly divided into a low molecular weight heparin+small dose unfractionated heparin pulse group (observation group, 18 cases) and a low molecular weight heparin application group merely (control group, 17 cases) by a random number table method.Thrombolysis effect was assessed by dynamic examination of plasma D-dimer.After treatment completed, the curative effect was analyzed by measuring the difference in the circumference of the lower limbs before and after the operation and the venous patency score.  Results  The plasma D-dimer in the observation group and control group increased during the thrombolysis process (day 3) were (78.26±11.57) and (66.06±12.31) mg/L (t=3.020, P=0.005).The circumference of 15 cm below the knee joint were (1.43±0.34) and (2.48±0.63) cm (t=6.185, P < 0.001);the lower extremity venous patency score was 5.34±0.90 and 7.29±1.19(t=5.235, P < 0.001);the dosage of urokinase were (302.22±20.45)×104 and (381.17±27.59)×104 units (t=9.656, P < 0.001).The comparison of the above two groups of data was statistically significant.  Conclusion  The efficacy of low molecular weight heparin combined with small dose unfractionated heparin pulse anticoagulation of CDT in DVT is excellent and safe.It should be popularized and applied in clinical treatment of lower extremity DVT.

     

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  • [1]
    王孝高, 王颖, 宋涛, 等. D-二聚体在下肢深静脉血栓形成导管溶栓过程中疗效评估的作用[J]. 重庆医学, 2020, 49(10): 1593-1596. doi: 10.3969/j.issn.1671-8348.2020.10.010

    WANG X G, WANG Y, SONG T, et al. The value of plasma D-dimer in Catheter-directed thrombectomy of deep venous thrombosis of lower extremities The value of plasma D-dimer in Catheter-directed thrombectomy of deep venous thrombosis of lower extremitie[J]. Chongqing Medical Journal, 2020, 49(10): 1593-1596. doi: 10.3969/j.issn.1671-8348.2020.10.010
    [2]
    王颖, 王孝高, 宋涛, 等. 肺动脉栓塞合并急性下肢深静脉血栓形成的类型比例分析与解读[J]. 中华全科医学, 2018, 16: (1): 107-109. doi: 10.16766/j.cnki.issn.1674-4152.000031

    WANG Y, WANG X G, SONG T, et al. Analysis and interpretation of the type of pulmonary embolism complicated with deep venous thrombosis of the lower extremities[J]. Chinese Journal of General Practice, 2018, 16: (1): 107-109. doi: 10.16766/j.cnki.issn.1674-4152.000031
    [3]
    王孝高, 王颖, 阿约德·菲利普·阿德戈克, 等. 导管溶栓联合髂静脉一期成型在下肢深静脉血栓形成中的应用[J]. 世界最新医学信息文摘, 2021, 21(98): 126-127. doi: 10.3969/j.issn.1671-3141.2021.98.059

    WANG X G, WANG Y, AVODE P A, et al. Application of catheter thrombolysis combined with primary iliac vein angioplasty in deep vein thrombosis of lower extremity[J]. Digest World Latest Med Inf, 2021, 21(98): 126-127. doi: 10.3969/j.issn.1671-3141.2021.98.059
    [4]
    XU Y J, WANG X M, SHANG D, et al. Outcome of AngioJet mechanical thrombus aspiration in the treatment of acute lower extremities deep venous thrombosis[J]. Vascular, 2020, 29(3): 415-423. http://pubmed.ncbi.nlm.nih.gov/32957848/
    [5]
    LIU G, ZHAO Z, CUI C, et al. Endovascular management of extensive lower extremity acute deep vein thrombosis with AngioJet rheolytic thrombectomy plus catheter-directed thrombolysis from contralateral femoral access[J]. Phlebology, 2019, 34(4): 257-265. doi: 10.1177/0268355518790407
    [6]
    陈海瑞, 张剑平, 王孝高, 等. 不同给药方法在下肢深静脉血栓导管溶栓过程中的对比研究[J]. 中华全科医学, 2021, 19(5): 782-785. doi: 10.16766/j.cnki.issn.1674-4152.001916

    CHEN H R, ZHANG J P, WANG X G, et al. Comparative study of different drug delivery methods in the catheter-directed thrombectomy for deep venous thrombosis in lower extremities[J]. Chinese Journal of General Practice, 2021, 19(5): 782-785. doi: 10.16766/j.cnki.issn.1674-4152.001916
    [7]
    YIN S W, GUO L W, BIAN L, et al. Evaluation of percutaneous mechanical thrombectomy via the AngioJet system combined with catheter-directed thrombolysis for the treatment of symptomatic lower extremity deep venous thrombosis[J]. Ann Vasc Surg, 2020, 65: 66-71. doi: 10.1016/j.avsg.2019.11.014
    [8]
    孙勇, 余朝文, 卢冉, 等. 经导管持续溶栓联合间歇性脉冲抗凝治疗急性下肢深静脉血栓的效果观察[J]. 蚌埠医学院学报, 2018, 43(8): 1016-1018, 1021. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201808011.htm

    SUN Y, YU C W, LU R, et al. Effect of cathter-directed thrombolysis combined with intermittent pulsed anticoagulation in the treatment of acute deep venous thrombosis of the lower extremity[J]. Journal of Bengbu Medical College, 2018, 43(8): 1016-1018, 1021. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG201808011.htm
    [9]
    CHOI Y J, KIM D H, KIM D I, et al. Comparison of treatment result between anticoagulation alone and catheter-directed thrombolysis plus anticoagulation in acute lower extremity deep vein thrombosis[J]. Vasc Specialist Int, 2019, 35(1): 28-33. doi: 10.5758/vsi.2019.35.1.28
    [10]
    LOFFROY R, FALVO N, GUILLEN K, et al. Single-session percutaneous mechanical thrombectomy using the Aspirex®S device plus stenting for acute iliofemoral deep vein thrombosis: safety, efficacy, and mid-term outcomes[J]. Diagnostics, 2020, 10(8): 544. DOI: 10.3390/diagnostics10080544.
    [11]
    NIE M L, WANG H Y, FU J, et al. Outcomes of Aspirex®S thrombectomy system combined with catheter-directed thrombolysis for treating bilateral lower extremity deep venous thrombosis[J]. Vascular Surgery, 2021, 9(5): 1112-1118.
    [12]
    黄薇薇, 门岚, 刘花, 等. 血浆纤维蛋白原、D二聚体及Caprini风险评估模型预测脑胶质瘤术后下肢深静脉血栓栓塞症的价值对比[J]. 中国实验诊断学, 2021, 25(9): 1325-1328. doi: 10.3969/j.issn.1007-4287.2021.09.018

    HUANG W W, MEN L, LIU H, et al. Comparison of plasma fibrinogen, D-dimer and caprini risk assessment model in predicting deep venous thromboembolism of lower limbs after glioma surgery[J]. Chin J Lab Diagn, 2021, 25(9): 1325-1328. doi: 10.3969/j.issn.1007-4287.2021.09.018
    [13]
    王丽萍, 冯江毅, 郭轶, 等. 超声引导下的3种入路置管溶栓方案治疗混合性下肢深静脉血栓的疗效比较[J]. 重庆医学, 2022, 51(1): 97-101. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202201021.htm

    WANG L P, FENG J Y, GUO T, et al. Comparison of the therapeutic effects of three kinds of catheterization and thrombolysis schemes guided by ultrasound in the treatment of mixed deep venous thrombosis of lower limbs[J]. Chongqing Medical Journal, 2022, 51(1): 97-101. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202201021.htm
    [14]
    SONG X J, LIU Z L, ZENG R, et al. The efficacy and safety of AngioJet rheolytic thrombectomy in the treatment of subacute deep venous thrombosis in lower extremity[J]. Ann Vasc Surg, 2019, 58: 295-301. http://www.ncbi.nlm.nih.gov/pubmed/30769071
    [15]
    MARRON R M, RALI P, HOUNTRAS P, et al. Inferior vena cava filters: past, present, and future[J]. Chest, 2020, 158(6): 2579-2589.
    [16]
    张福先, 李晓强, 刘建龙, 等. 腔静脉滤器临床应用指南[J]. 中国实用外科杂志, 2019, 39(7): 651-654. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201907002.htm

    ZHANG F X, LI X Q, LIU J L, et al. Clinical application guideline of vena cava filte[J]. Chin J Pract Surg, 2019, 39(7): 651-654. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201907002.htm
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