恶性肿瘤引起髂股静脉重度狭窄继发下肢深静脉血栓形成的介入治疗  

Interventional treatment of deep venous thrombosis of lower extremity secondary to severe iliofemoral vein stenosis caused by malignant tumor

作　　者：俞靖凡 金泳海[1] 黄天安 樊宝瑞[1] 倪才方[1] YU Jingfan;JIN Yonghai;HUANG Tian'an;FAN Baorui;NI Caifang(Department of Vascular and Interventional,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China;Department of Interventional,Nantong First People's Hos pital,Nantong,Jiangsu Province 226000,China)

机构地区：[1]苏州大学附属第一医院介入血管科,江苏苏州215006 [2]南通市第一人民医院介入科,江苏南通226000

出　　处：《实用放射学杂志》2021年第2期296-299,共4页Journal of Practical Radiology

摘　　要：目的探讨恶性肿瘤引起的髂股静脉受压重度狭窄继发下肢深静脉血栓形成的介入治疗的安全性及有效性。方法回顾性分析因恶性肿瘤引起髂股静脉重度狭窄继发下肢深静脉血栓形成的患者临床资料。采用球囊辅助碎栓、血栓抽吸、经导管溶栓、支架植入等介入治疗。统计并分析患肢消肿率,患肢血栓清除率;术后第1、3、6、12个月进行门诊随访,行下肢静脉彩色多普勒超声、盆腔CT或下肢静脉造影检查了解下肢深静脉及支架内血流通畅情况;记录治疗及随访期间并发症。结果共纳入24例患者。术前、术后患侧和健侧大、小腿周径差(患肢消肿率)均有显著统计学差异(t=7.47,t=8.07,P=0.000);平均血栓清除率85.40%±9.07%,血栓清除率评级为Ⅱ级、Ⅲ级的病例数分别为18例、6例;随访期一期通畅率、二期通畅率为100%。2例患者出现严重并发症。结论介入治疗恶性肿瘤引起的髂股静脉重度狭窄继发下肢深静脉血栓形成是安全有效的,应注意预防、早期识别并即时治疗相关并发症。Oljective To investigate the fficacy and safety of interventional treatment of deep venous thrombosis of lower extremities scondary to severe iliofemoral vein stenosis caused by malignant tumor.Methods The elinical data of patients admitted to our department with deep venous thrombosis of lower extremities secondary to severe iliofemoral vein stenosis caused by malignant tumor were analyzed retrosectively.Blloon assisted thrombolysis,thrombus aspiration.transcatheter thrombolysis and stent implantation were used for interventional therapy.The swelling regression rate and thrombus clearance rate of the afected limb were analyzed.Outpatient follow-up was conducted at the 1 st,3 rd,6 th and 12 th month after the operation.Venous color Doppler ultrasound of lower extremities,pelvic CT or venous angiography of lower extremities were performed to investigate the patency of blood flow in the deep veins of lower extremities and the stents.Complcations were recorded during treatment and follow up.Results A total of 24 patients were included.There were stitically significant dflerences in D-values of thigh and leg circumstance before and after operation(t=7.47,t=8.07,P=0.000).The average thrombus removal rate was(85.40%±9.07%).The number of patients with thrombus clearance rate of grade Ⅱ and grade Ⅰ was 18 and 6,respectively.During the fllow up period,the primary patency rate and secondary patency rate were all 100%.Two patients developed serious complications.Conclusion Interventional treatment of lower extremity deep venous thrombosis scondary to severe iliofemoral vein stenosis caused by malignant tumor is safe and efctive Attention should be paid to the prevention,carly identification and immediate treatment of related complications.

关 键 词：恶性肿瘤 髂静脉狭窄 深静脉血栓形成 介入治疗 

分 类 号：R730.6[医药卫生—肿瘤] R543.6[医药卫生—临床医学]