盆腔放疗后髂静脉狭窄的介入治疗  

Interventional treatment of iliac vein stenosis after pelvic radiotherapy

作　　者：陈述[1] 权晖 杨哲[2] 李金保[1] 于伟峰[1] 毕远航 付浩哲 CHEN Shu;QUAN Hui;YANG Zhe;LI Jinbao;YU Weifeng;BI Yuanhang;FU Haozhe(Department of Interventional Vascular Surgery, Baoji Municipal Central Hospital, Baoji, Shaanxi Province 721008, China)

机构地区：[1]宝鸡市中心医院介入血管外科,陕西721008 [2]宝鸡市中心医院放疗科,陕西721008

出　　处：《介入放射学杂志》2018年第6期569-572,共4页Journal of Interventional Radiology

摘　　要：目的 探讨盆腔放疗后下肢水肿的病因及治疗方式。方法 回顾性分析2015年1月至2017年7月收治的137例接受盆腔放疗后出现下肢持续性水肿患者的临床资料,经过彩色多普勒及静脉顺行造影检查,57例患者诊断为髂静脉狭窄,29例接受球囊扩张及支架植入术治疗。结果 29例患者经过介入治疗,患肢水肿快速消退。其中3例(10.3%)患者术后仍有间歇水肿,但较术前明显减轻,复查显示支架内血流通畅。结论 髂静脉狭窄可能是引起盆腔放疗后下肢水肿的重要原因,有必要进行影像学检查评估;介入治疗能有效重建静脉回流通道,缓解患肢肿胀,提高患者生存质量。Objective To investigate the etiology and treatment of edema of lower extremity occurring after pelvic radiotherapy. Methods The clinical data of 137 patients, who were admitted to authors＂ hospital to receive pelvic radiotherapy during the period from January 2015 to July 2017 and developed persistent edema of lower limb after pelvic radiotherapy, were retrospectively analyzed. Color Doppler ultrasonography and antegrade venography confirmed the diagnosis of iliac vein stenosis in 57 patients, among whom 29 patients received interventional balloon dilatation and stent implantation. Results After interventional treatment, the edema of the affected limb subsided rapidly in all 29 patients. Among them, intermittent edema was observed in 3 patients （10.3%）, but the degree of edema was significantly improved when compared with the preoperative condition. The follow-up examination showed that the blood flow in the stent was smooth. Conclusion Iliac vein stenosis may be an important cause of lower extremity edema after pelvic radiotherapy, it is necessary to evaluate iliac vein lumen with imaging examination before making treatment plan. Interventional therapy can effectively reconstruct venous return channel, thus, the limb swelling can be rapidly relieved and the quality of life of patients can be improved.

关 键 词：髂静脉狭窄 盆腔放疗 介入治疗 

分 类 号：R543.5[医药卫生—心血管疾病]