腘静脉置管溶栓联合髂静脉支架治疗髂股静脉血栓  

Catheter of popliteal vein thrombolysis combined with iliac vein intraluminal stenting in the treatment of iliofemoral deep venous thrombosis

作　　者：董典宁[1] 张十一[1] 金星[1] 吴学君[1] 种振岳[1] 李国建 张精勇[1] 孙岩[1] 

机构地区：[1]山东省立医院血管外科,山东济南250021 [2]山东省枣庄矿业集团枣庄医院外科,山东枣庄277101

出　　处：《中国实用外科杂志》2007年第3期232-234,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨腘静脉置管溶栓联合髂静脉球囊扩张或支架植入术治疗髂股静脉血栓的临床疗效。方法回顾性分析山东省立医院血管外科2004年2月至2006年9月收治的30例髂股静脉血栓，均采用超声引导下惠肢腘静脉置管溶栓联合髂股静脉球囊扩张或支架植入的方法进行治疗。其中15例行球囊扩张及髂静脉支架术，5例行单纯球囊扩张术，20例行临时性下腔静脉滤器置入术。术中以及静脉造影评价静脉通畅程度，门诊以彩超随访髂静脉通畅率。结果置管溶栓后经导管静脉造影显示髂静脉再通率30％-90％（平均55％），股静脉再通率40％-100％（平均70％）。术后患肢临床症状明显减轻或消失。住院费用（5．2—8．4）万元，平均7．7万元，30例随访1-31个月，平均11个月，25例髂静脉支架植入者髂静脉通畅率100％，5例单纯球囊扩张者髂静脉再通率0—20％。结论腘静脉置管溶栓术联合髂静脉支架植入术是治疗髂股静脉血栓的安全有效方法之一，但是价格昂贵，广泛临床应用困难，远期效果有待于进一步随访。Objective To discuss the clinical effect of catheter-based thrombolysis combined with intraluminal dilatating and stenting on iliofemoral venous thrombosis. Methods The clinical data of 30 cases of iliofemoral venous thrombosis admitted between February 20（0 and September 2006 in Shandong Provincial Hospital were analyzed retrospectively. All the cases were performed catheter of popliteal vein thrombolysis guided by B-ultrasound combined with intraluminal dilatating and stenting in the iliofemoral vein. The clinical therapeutic effect and short follow-up outcome were analyzed. Results Catheter-based thrombolysis through the ipsilateral popliteal vein was effective for all the cases. Balloon dilatation angioplasty combined with endovascular stenting was applied for 25 patients. Balloon dilatation angioplasty alone was applied for the other 5 patients. The follow-up time was 1 - 31 months and the patency rate of stent in iliac vein was 100%. The short-term follow-up outcome was satisfactory. Conclusion Catheter of popliteal vein thrombolysis combined with iliac vein intraluminal stenting is a effective therapeutic strategy for the iliofemoral venous thrombosis, but it is very expensive. The long-term follow-up is necessary.

关 键 词：深静脉血栓形成 髂股静脉 腘静脉置管 溶栓 血管支架 

分 类 号：R6[医药卫生—外科学]