AngioJet吸栓联合支架植入治疗急性下肢深静脉血栓形成合并髂静脉狭窄的短期疗效  

Short-term effect of AngioJet thrombectomy combined with stent implantation on acute lower extremity deep vein thrombosis with iliac vein stenosis

作　　者：叶琨[1] 万圣云[1] 丁洋[1] Ye Kun;Wan Shengyun;Ding Yang(Department of General Surgery,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院普通外科,合肥230601

出　　处：《中国血管外科杂志（电子版）》2020年第4期314-318,共5页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的评价AngioJet吸栓联合支架植入治疗急性下肢深静脉血栓形成合并髂静脉狭窄的疗效,并比较同期植入支架与分期植入支架的疗效差异。方法回顾性分析2017年1月至2019年12月安徽医科大学第二附属医院采用AngioJet吸栓联合髂静脉支架植入术治疗的60例急性下肢深静脉血栓形成患者资料。结果术后即刻Ⅰ级、Ⅱ级和Ⅲ级血栓清除率分别为0、8.3%和91.7%,术后平均随访2年,髂静脉支架通畅率达95.0%(57/60),血栓形成后综合征发生率为35.0%(21/60)。同期组即刻临床缓解率高于分期组(93.3%vs 63.3%),住院天数少于分期组[(5.17±0.91)d vs(6.40±0.97)d],Villata评分[(3.37±1.40)分vs(4.33±1.37)分]和Vein-Qol评分[(25.00±2.61)分vs(31.63±2.57)分]均低于分期组,差异有统计学意义(P<0.05);两组患者的大腿周径差[(8.23±2.73)cm vs(7.10±1.97)cm]、静脉反流时间[(1.25±0.39)s vs(1.28±0.41)s]、支架通畅率(96.7%vs 93.3%)和血栓形成后综合征发生率(26.7%vs 43.3%)等比较差异无统计学意义(P>0.05)。结论AngioJet吸栓联合支架植入治疗急性下肢深静脉血栓形成合并髂静脉狭窄的短期疗效满意,同期支架植入和分期植入相比有更好的效果。Objective To evaluate the outcomes of patients with acute lower extremity deep vein thrombosis and iliac vein stenosis who underwent AngioJet thrombectomy combined with iliac vein stent implantation,and to compare the effect of simultaneous implantation and staged implantation of stents.Methods The clinical data of 60 patients with acute deep vein thrombosis of the lower extremities treated by AngioJet thrombectomy combined with iliac vein stent implantation in the Second Affiliated Hospital of Anhui Medical University from January 2017 to December 2019 were analyzed retrospectively.Results The instant postoperative thrombus clearance rates of gradeⅠ,ⅡandⅢwere 0,8.3%and 91.7%,respectively.The average follow-up time was 2 years.The patency rate of iliac vein stent was 95.0%(57/60)and incidence rate of post-thrombotic syndrome was 35.0%(21/60).The immediate clinical remission rate of the simultaneous implantation group was higher than staged implantation group(93.3%vs 63.3%),the hospital stays was less than staged implantation group[(5.17±0.91)d vs(6.40±0.97)d],and the Villata score[(3.37±1.40)vs(4.33±1.37)]and Vein-Qol scores[(25.00±2.61)vs(31.63±2.57)]were lower than staged implantation group,the difference was statistically significant(P<0.05).There was no significant difference in the thigh circumference difference[(8.23±2.73)cm vs(7.10±1.97)cm],venous reflux time[(1.25±0.39)s vs(1.28±0.41)s],stent patency rate(96.7%vs 93.3%)and incidence rate of post-thrombotic syndrome(26.7%vs 43.3%)between imultaneous implantation group and staged implantation group(P>0.05).Conclusion AngioJet thrombectomy combined with stent implantation has satisfactory short-term effects in the treatment of acute deep vein thrombosis of lower extremities with iliac vein stenosis.Simultaneous stent implantation has better results than staged implantation.

关 键 词：深静脉血栓形成 髂静脉狭窄 机械血栓清除 支架植入 

分 类 号：R654.4[医药卫生—外科学]