髂静脉受压综合征及继发血栓形成的介入治疗  

Interventional therapy for lilac vein compression syndrome and secondary thrombosis

作　　者：顾建平[1] 楼文胜[1] 何旭[1] 陈亮[1] 陈国平[1] 苏浩波[1] 宋进华[1] 汪涛[1] 

机构地区：[1]南京医科大学附属南京第一医院介入放射科,210006

出　　处：《中华放射学杂志》2008年第8期821-825,共5页Chinese Journal of Radiology

基　　金：国家科技部“十一五”科技支撑计划资助项目（2006038073024）

摘　　要：目的探讨髂静脉受压综合征（ICS）及继发深静脉血栓形成（DVT）的介入治疗效果。方法回顾性分析125例经DSA明确诊断为ICS及继发DVT的患者资料，其中单纯ICS患者39例，ICS继发DVT患者86例。对不伴有新鲜血栓的髂静脉受压及髂静脉狭窄、闭塞的患者行经皮腔内血管成形术和自膨支架置入术，对伴有髂、股静脉新鲜血栓的髂静脉受压患者在置入下腔静脉滤器后行经导管血栓抽吸、机械性血栓消融、腔内血管成形、支架置入术及经导管溶栓。采用卡方检验对单纯ICS患者及ICS继发DVT患者出院时和出院后6个月的治疗有效率和优良率进行比较。结果39例单纯ICS患者中，38例实施了腔内成形和支架置入术；86例继发有DVT的ICS中，83例实施了各种腔内介入治疗。ICS患者及ICS继发DVT患者出院时的治疗有效率分别为97．4％（38／39）和96．5％（83／86），出院后6个月分别为96．3％（26／27）和90．2％（46／51），差异均无统计学意义（X^2值分别为0．000和0．266，P值均〉0．05）；ICS患者及ICS继发DVT患者出院时的治疗优良率分别为94．9％（37／39）和79．1％（68／86），出院后6个月分别为92．6％（25／27）和68．6％（35／51），差异均有统计学意义（X^2值分别为3．879和4．441，P值均〈0．05）。结论介入治疗ICS及继发DVT安全、有效，并且应尽早发现和处理ICS。Objective To evaluate the value of interventional therapy in treatment of iliac compression syndrome （ICS） and subsequent venous thrombosis. Methods Examined by DSA, 125 cases were diagnosed of iliac vein compression and subsequent thrombosis. In 39 cases of ICS （ group 1 ） , left： fight = 4.6： 1. In 86 cases of ICS complicated with subsequent thrombosis （group 2）, left： right = 4. 7： 1. The patients of iliac vein compression and compression-related iliac vein stenosis or occlusion without fresh thrombus were treated by percutaneous transluminal angioplasty （PTA） and self-expandable stenting. In those cases with fresh thrombosis the inferior vena cava filter were inserted before thrombosis suction, mechanical thrombus ablation, PTA, stenting and transcatheter thrombolysis. The Chi-square test for comparison of proportions was used to test statistical significance. Results In 39 cases of ICS, 38 cases were treated by PTA and stenting. In 86 cases of deep vein thrombosis complicated with ICS, 83 cases were treated by various interventional therapy. There was no significant difference in the efficiency of intraluminal treatment between the two groups at discharge （97. 4% and 96. 5%, X2 =0. 000,P 〉0. 05） and at 6 months follow-up（96.3% and 90. 2% , X^2 = 0. 266, P 〉 0. 05 ） , the difference in excellent-good rate of the two groups was significant at discharge（94. 9% and 79. 1% , X^2 = 3. 879, P 〈 0. 05 ） and at 6 months follow-up （92.6% and 68. 6%, X^2 = 4. 441,P 〈 0. 05 ）. Conclusions Interventional treatment for ICS and secondary thrombosis is safe and effective.

关 键 词：髂静脉 静脉血栓形成 放射学 介入性 

分 类 号：R686[医药卫生—骨科学]