介入治疗急性髂股静脉血栓:血栓清除等级差异对疗效的影响  

The difference in grade of thrombus clearance in interventional therapy performed for acute iliofemoral vein thrombosis: comparison of 2-year follow-up study

作　　者：闫乐乐 黄天安 印于 吕朋华 YAN Le-le;HUANG Tian-an;YIN Yu;LV Peng-hua(Department of Interventional Radiology,Northern Jiangsu People’s Hospital,Jiangsu 225000,China)

机构地区：[1]苏北人民医院介入科,江苏扬州225000 [2]南通市第一人民医院介入科,江苏南通226001 [3]苏州大学附属第一医院介入科,江苏苏州215006

出　　处：《影像诊断与介入放射学》2021年第3期178-183,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的比较急性髂股静脉血栓行介入治疗后,血栓清除等级差异是否影响术后2年临床疗效。方法回顾性分析2017年6月~2019年12月收治的85例急性髂股静脉血栓病例资料。所有患者均行介入血栓清除,其中42例血栓清除等级为Ⅱ级(A组),43例清除等级为Ⅲ级(B组)。随访2年,比较两组患者出血发生率、出院前下肢消肿率、深静脉通畅率、患肢血栓复发率、血栓后综合征(PTS)发生率及其严重程度、慢性静脉功能不全问卷(CIVIQ)评分差异。结果血栓清除等级Ⅱ级组与Ⅲ级组相比,出血发生率无统计学差异[9.5%(4/42)比2.3%(1/43),P=0.202],患肢消肿率差异有统计学差异[大腿消肿率:(66.71±13.63)%比(79.33±9.42)%,P=0.000;小腿消肿率:(71.45±10.05)%比(81.09±8.53)%,P=0.000]。平均随访(15.16±5.93)个月,深静脉通畅率[66.7%(28/42)比83.7%(36/43),P=0.082]、患肢血栓复发率[7.1%(3/42)比0.0%(0/43),P=0.116]、PTS发生率[42.9%(18/42)比30.2%(13/43),P=0.265]、严重PTS发生率[61.1%(11/18)比30.8%(4/13),P=0.149]及CIVIQ评分差异[(66.90±15.99)比(72.47±13.84),P=0.090]均无统计学差异。结论介入治疗急性髂股静脉血栓,难以避免血栓清除等级Ⅱ级的结果,其与清除等级Ⅲ级相比,虽无法显著改善患肢肿胀症状,但可改善患者术后2年预后。Objective To investigate the 2-year follow-up of thrombus clearance after interventional therapy for acute iliofemoral vein thrombosis.Methods The clinical records of patients who underwent interventional thrombus clearance treatment for acute iliofemoral vein thrombosis between June 2017 and December 2019 were retrospectively analyzed.The patients were divided into group A(n=42,gradeⅡof thrombus clearance)and group B(n=43,gradeⅢof thrombus clearance).In the 2-year follow-up,the incidence of bleeding rate,regression rate of lower limb swelling at the time of discharge,deep vein patency rate,recurrence rate of vein thrombosis,incidence and severity of post thrombotic syndrome(PTS),and difference of chronic venous insufficiency survey scale(CIVIQ)were compared between the two groups.Results There was no significant difference(P=0.202)in the incidence of bleeding rates between group A(9.5%,4/42)and group B(2.3%,1/43)whereas the regression rate of lower limb swelling at the time of discharge was significantly higher(P=0,0)in group B(79.33±9.42%,81.09±8.53%)than group A(66.71±13.63%,71.45±10.05%)in the thigh and calf,respectively.In the mean follow-up period of 15.16±5.93 months,there were no significant differences between groups A and B with respect to deep vein patency rate(66.7%,28/42;83.7%,36/43;P=0.082),recurrence rate of vein thrombosis(7.1%,3/42;0%,0/43;P=0.116),incidence of PTS(42.9%,18/42;30.2%,13/43;P=0.265),incidence of severe PTS(61.1%,11/18;30.8%,4/13;P=0.149),and difference of CIVIQ(66.90±15.99;72.47±13.84;P=0.090).Conclusion In patients with interventional therapy for acute iliofemoral vein thrombosis,it was difficult to avoid the gradeⅡof thrombus clearance.Although it did not significantly improve the swelling of the affected limb in comparison with gradeⅢof thrombus clearance,it can improve the 2-year prognosis.

关 键 词：血栓清除等级 急性髂股静脉血栓形成 临床疗效 随访研究 

分 类 号：R364.15[医药卫生—病理学] R543.6[医药卫生—基础医学]