一站式介入治疗在处理Cockett综合征急性髂股静脉血栓形成中的应用  

Application of one-stop interventional therapy in the treatment of acute iliofemoral deep venous thrombosis with Cockett syndrome

作　　者：黄天安 赵佳 金泳海[1] 丁文彬[2] 樊宝瑞[1] 印于 俞靖凡 HUANG Tian-an;ZHAO Jia;JIN Yong-hai;DING Wen-bin;FAN Bao-rui;YIN Yu;YU Jing-fan(Department of Vascular and Interventional Radiology,The First Affiliated Hospital of Soochow University,Jiangsu 215006,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226001

出　　处：《影像诊断与介入放射学》2021年第3期184-189,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的总结一站式介入治疗在处理Cockett综合征急性髂股静脉血栓形成中的应用体会。方法收集2016年6月~2018年12月采用一站式介入治疗Cockett综合征急性髂股静脉血栓形成患者临床资料。入选标准:(1)临床症状发生时间不超过7 d。(2)造影明确为合并Cockett综合征的髂股静脉血栓。所有患者均尝试一站式介入治疗,方案为:球囊扩张联合AngioJet血栓抽吸,同期滤器回收,同期髂静脉支架置入。无溶栓禁忌患者,术后常规尿激酶溶栓24 h后造影复查。结果62例患者,平均病程(3.52±2.33)d,(6 h~7 d);50例成功完成一站式介入治疗,占80.64%(50/62);另12例至少行二次介入治疗。不同就诊途径之间,一站式介入治疗成功比例存在统计学差异[住院对比门急诊病例;(93.3%,28/30)比(68.8%,22/32),P=0.023]。所有患者围手术期间,无肺栓塞、出血等严重并发症发生。结论一站式介入治疗在处理Cockett综合征急性髂股静脉血栓形成中是一种可行的方案,尤其针对发病时间不超过7 d的已住院患者,但受静脉血栓实际形成时间的影响。Objective To summarize the experience of one-stop interventional therapy in the treatment of acute iliofemoral deep venous thrombosis(DVT)with Cockett syndrome.Methods From July 2016 to December 2018,retrospectively collected the clinical data of patients with acute iliofemoral DVT with Cockett syndrome under the treatment of one-stop interventional therapy.The inclusion criteria were listed as below:①the onset of clinical symptoms was less than or equal to 7 days;②iliofemoral DVT with Cockett syndrome was confirmed by angiography.All patients were treated with one-stop interventional therapy,which consisted of balloon dilation combined with AngioJet thrombus aspiration,simultaneous filter recovery,and simultaneous iliac vein stent implantation.Patients with no contraindication to thrombolysis were examined by angiography 24 h after routine urokinase thrombolysis.Results 62 patients were finally included,and the average course of the disease was(3.52±2.33)d,with the shortest duration of 6 h and the longest duration of 7 d.Fifty patients completed one-stop interventional therapy,accounting for 80.64%(50/62);the other 12 cases all received at least secondary interventional therapy.There was a statistically significant difference in the success rate of one-stop interventional therapy among different approaches[(hospitalization)vs.outpatient and emergency department;(93.3%,28/30)vs.68.8%,22/32),P=0.023].No serious complications such as pulmonary embolism and hemorrhage occurred in all patients during the perioperative period.Conclusion One-stop interventional therapy is a feasible approach for acute iliofemoral DVT with Cockett syndrome,especially for hospitalized patients whose onset time is less than or equal to 7 days,but who are affected by the actual formation time of DVT.

关 键 词：髂股静脉血栓形成 介入治疗 机械性血栓清除术 COCKETT综合征 

分 类 号：R543.6[医药卫生—心血管疾病]