同期或分期腔内治疗May-Thurner综合征伴左下肢静脉曲张效果比较  

Simultaneous versus staged endovascular treatment of May-Thurner syndrome associated with varicose veins of left lower extremity:comparison of the therapeutic effect

作　　者：孙洋 徐一丁 张杰[1] 杨超[1] 段鹏飞[1] 王孝运 倪才方[1] SUN Yang;XU Yiding;ZHANG Jie;YANG Chao;DUAN Pengfei;WANG Xiaoyun;NI Caifang(Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]苏州大学附属第一医院介入血管科,江苏215006

出　　处：《介入放射学杂志》2020年第2期186-190,共5页Journal of Interventional Radiology

基　　金：江苏省卫生厅科技项目(H201419)。

摘　　要：目的探讨同期或分期腔内治疗May-Thurner综合征伴左下肢静脉曲张效果差异。方法收集2016年9月至2018年3月收治的37例May-Thurner综合征伴左下肢静脉曲张患者临床资料,其中23例接受同期治疗左髂静脉狭窄和静脉曲张(A组),14例接受分期治疗(先治疗左髂静脉狭窄,1个月后再治疗静脉曲张,B组)。回顾性分析两组患者术后并发症发生情况、住院时间、住院费用以及随访6个月后髂静脉支架通畅率、下肢肿胀缓解率、疼痛缓解率、静脉溃疡愈合率和静脉疾病临床严重度评分(VCSS)。结果37例手术均获成功。术后A组2例、B组1例发生皮下瘀血,两组各1例发生皮肤灼伤和切口感染,A组1例出现下肢皮疹,B组1例出现小腿皮肤感觉异常。无左股静脉穿刺点出血和下肢深静脉血栓、肺栓塞并发症发生。A、B组住院时间分别为(9.04±1.66)d、(15.71±2.02)d,住院费用分别为(3.58±0.63)万元、(4.11±0.46)万元,差异均有统计学意义(P<0.05)。随访6个月,两组髂静脉支架通畅率、下肢肿胀缓解率、疼痛缓解率和静脉溃疡愈合率差异均无统计学意义(P>0.05),两组间术前、两组间术后VCSS评分比较差异均无统计学意义(P>0.05),但各组术前与术后VCSS评分差异均有统计学意义(P<0.05)。结论对May-Thurner综合征伴左下肢静脉曲张的患者选择同期或分期治疗均不影响手术近期疗效,但同期治疗可减少患者住院时间和费用。Objective To evaluate the therapeutic efficacy of simultaneous endovascular therapy and staged endovascular therapy in treating May-Thurner syndrome associated with varicose veins of left lower extremity.Methods The clinical data of 37 patients with May-Thurner syndrome complicated by varicose veins of left lower extremity,who were admitted to authors’hospital to receive treatment during the period from September 2016 to March 2018,were collected.Of the 37 patients,23 received simultaneous treatment of left iliac vein stenosis and varicose veins(group A)and 14 received staged treatment(group B),i.e.the left iliac vein stenosis was treated first,and one month later the varicose vein was treated.The postoperative complications,hospitalization days,hospitalization expenses,and the iliac vein stent patency rate,lower limb swelling remission rate,pain relief rate,venous ulcer healing rate and venous clinical severity score(VCSS)of venous disease at 6 months after treatment were compared between the two groups.Results Successful endovascular treatment was achieved in all 37 patients.Postoperative subcutaneous congestion was observed in 2 patients of group A and one patient of group B.One patient in each group developed skin burns and wound infections.One patient in group A had skin rash of lower extremy,and one patient in group B had abnormal skin sensation of leg.No puncture point hemorrhage of left femoral vein,deep venous thrombosis of lower extremities,or pulmonary embolism occurred.The hospitalization days of group A and group B were(9.04±1.66)days and(15.71±2.02)days respectively,the hospitalization expenses in group A and group B were(3.58±0.63)and(4.11±0.46)ten thousand Chinese yuan respectively,and the differences in the above two indexes between group A and group B were statistically significant(P<0.05).The patients were followed up for 6 months,and no statistically significant differences in iliac vein stent patency rate,lower limb swelling relief rate,pain relief rate and venous ulcer healing rate exi

关 键 词：May-Thurner综合征 左下肢静脉曲张 腔内治疗 

分 类 号：R711[医药卫生—妇产科学]