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Efficacy of Urokinase and catheter thrombolysis in Treating Acute Lower Limb DVT and Its influence on Coagulation Index

Objective 
To investigate the efficacy of urokinase and catheter thrombolysis in treating acute lower limb DVT and influence on coagulation indexes. 
 
 
Methods 
A retrospective analysis was performed in 52 patients with acute lower limb DVT from June 2015 to June 2017, who were divided into catheter thrombolysis group (n=30) and system thrombolytic group (n=22). Statistical analysis were performed by using SPSS 21.0 software. Measurement data, such as thrombolytic rate, circumference difference of bilateral lower limb and blood coagulation index were expressed as ±s, and were examined by using independent t test. Count data such as adverse reactions and clinical signs are expressed as a percentage (%) and were examined by chi square test. A P value <0.05 was considered as statistically significant difference. 
 
 
Results 
There was no significant difference of preoperative venous patency scoring, circumference difference of bilateral lower limb, clinical symptoms and coagulation index between two groups (P>0.05). Intravenous patency scoring of 8.5±2.0 in catheterized thrombolytic group was significantly lower than 12.4±2.9 in the systemic thrombolytic group, (P=0.000). The thrombolytic rate of 56.2±26.0 in catheterized thrombolytic group was better than 39.9±23.9 in systemic thrombolysis group, with statistically significant difference (P=0.011). The difference of the median diameter between the middle thigh and the lower leg in catheterized thrombolytic group was significantly lower than that in the systemic thrombolytic group (P<0.05). The rate of postoperative lower extremity edema, the incidence of lower extremity pain and the rate of skin color change in the catheterized thrombolytic group were superior than those in the systemic thrombolytic group respectively (P<0.05). The incidence of gingival bleeding in catheter thrombolytic group (3.3%) was significantly lower than 27.3% in systemic thrombolysis group, the incidence of total adverse reactions (6.6%) was lower than 50.0% in system thrombolytic group, with statistically significant difference (P=0.001). The PT, APTT and TT in catheterized thrombolytic group were significantly higher than those in systemic thrombolysis group respectively (P<0.05), however FIB in catheterized thrombolytic group were significantly lower (P<0.05). 
 
 
Conclusion 
Urokinase and catheter thrombolysis in treating acute lower extremity DVT could achieve better clinical efficacy with lower incidence of adverse reactions and it has a significant effect on the coagulation index. 
 
 
Key words: 
Urokinase-Type Plasminogen Activator; Thrombolytic Therapy; Venous Thrombosis; Prothrombin Time