髂静脉支架在急性下肢深静脉血栓形成伴髂静脉压迫综合征患者中的应用  

Application of iliac vein stent in patients with acute deep venous thrombosis of lower extremity and iliac vein compression syndrome

作　　者：胡潍青[1] 刘宗芬 孙波[1] 裴长安[1] 张纪存 姜炎杰 张杰峰[1] HU Wei-Qing;LIU Zong-Fen;SUN Bo;PEI Chang-An;ZHANG Ji-Cun;JIANG Yan-Jie;ZHANG Jie-Feng(Department of Vascular Surgery,Weifang People′s Hospital,WeiFang 261041,Shandong Province,China;School of Clinical Medicine,Weifang Medical University,Weifang 261000,Shandong Province,China)

机构地区：[1]潍坊市人民医院血管外科,山东潍坊261041 [2]潍坊医学院临床医学院,山东潍坊261000

出　　处：《中华老年多器官疾病杂志》2021年第12期893-897,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：山东省潍坊市卫生健康委员会科研项目(wfwsjk_2019_005)。

摘　　要：目的探讨下肢深静脉血栓形成(DVT)伴髂静脉压迫综合征(IVCS)患者血栓清除术后行髂静脉支架治疗的效果。方法回顾性分析潍坊市人民医院2016年1月至2019年12月收治的83例急性下肢DVT伴IVCS、行血栓清除术患者的临床资料,其中单纯药物治疗组32例,支架治疗组51例。观察2组患者出院时肢体消肿率,术后6、12个月静脉通畅率及Villalta评分。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用t检验、χ^(2)检验或Fisher确切概率检验进行组间比较。结果单纯药物治疗组大腿与小腿消肿率分别为(29.75±11.74)%和(30.40±10.79)%,支架治疗组分别为(64.35±12.67)%和(61.0±18.89)%;单纯药物治疗组术后6、12个月静脉通畅率分别为87.50%和75.00%,支架治疗组分别为96.07%和92.15%;单纯药物治疗组术后6、12个月Villalta评分分别为(8.16±1.80)和(7.44±1.50),支架治疗组分别为(6.76±2.40)和(6.17±2.11);2组比较,差异均有统计学意义(P<0.05)。结论下肢DVT伴IVCS患者血栓清除术后一期行髂静脉支架治疗能显著提高静脉通畅率,改善下肢症状。Objective To evaluate the patency rate of iliac vein stenting after thrombectomy in patients of deep venous thrombosis(DVT)with iliac vein compression syndrome(IVCS,also known as May-Thurner syndrome or Cockett′s syndrome).Methods Clinical data of 83 patients with acute lower limb DVT with IVCS and undergoing thrombectomy treated in Weifang People′s Hospital from January 2016 to December 2019 were collected and analyzed retrospectively.According to their treatment,they were divided into drug group(n=32)and stent group(n=51).The detumescence rate of limbs at discharge,venous patency rate and Villalta score at 6 and 12 months after operation were employed as evaluation indexes,and compared between the two groups.SPSS statistics 22.0 was used to perform the statistical analysis.Student′s t test,Chi-square test,or Fisher exact probability test was employed for intergroup comparison depending on different data types.Results The detumescence rates of thigh and calf were(29.75±11.74)%and(30.40±10.79)%in the drug group,and(64.35±12.67)%and(61.0±18.89)%in the stent group,with significant differences between the two groups(all P<0.05).The venous patency rates at 6 and 12 months after operation were 87.50%and 75.00%in the drug group and 96.07%and 92.15%in the stent group,respectively.The Villalta scores at 6 and 12 months after operation were(8.16±1.80)and(7.44±1.50)in the drug group and(6.76±2.40)and(6.17±2.11)in the stent group,with statistical differences between the two groups(P<0.05).Conclusion One-stage iliac vein stent therapy can significantly improve the patency rate of vein and improve the symptoms of lower extremities after thrombectomy in patients with DVT and IVCS of lower extremities.

关 键 词：静脉血栓形成 髂静脉受压综合征 支架 血栓清除术 

分 类 号：R364.15[医药卫生—病理学]