急性下肢深静脉血栓形成合并Cockett综合征支架植入后抗凝治疗的效果分析  

Effect of anticoagulant therapy after stent implantation on acute deep venous thrombosis of lower extremity combined with Cockett syndrome

作　　者：黄伟彬 葛红卫[1] 吴元兵[1] 姜云飞[1] 朱永斌[1] 朱云峰[1] Huang Weibin;Ge Hongwei;Wu Yuanbing;Jiang Yunfei;Zhu Yongbin;Zhu Yunfeng(Department of Vascular Surgery,The Third Affiliated Hospital of Soochow University,The First People's Hospital of Changzhou,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院常州市第一人民医院血管外科,江苏常州213003

出　　处：《中国血管外科杂志（电子版）》2021年第4期323-326,331,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：常州市科学技术局应用基础研究项目(CJ20190101)。

摘　　要：目的评价下肢深静脉血栓形成合并Cockett综合征支架植入后不同抗凝时长的治疗效果。方法回顾性分析2016年9月至2020年5月于苏州大学附属第三医院行CDT联合髂静脉支架植入术治疗的28例急性下肢深静脉血栓形成患者的临床资料。患者根据其术后抗凝持续时间分为短期抗凝组(≤90 d)和延长抗凝组(>90 d),比较两组支架通畅率、肢体周径差、Villalta评分等指标。结果患者术后平均随访(16.8±2.6)个月,术后12个月的髂静脉支架一期通畅率为96.2%(25/26)。1例患者术后1个月出现支架闭塞,Villalta评分6分。两组患者术后12个月支架通畅率、肢体周径差和Villalta评分比较差异无统计学意义(P>0.05)。两组在随访期间各有1例患者出现牙龈出血,延长抗凝组有2例患者发生皮肤黏膜出血,但两组患者出血事件发生率差异无统计学意义(P>0.05),均无症状性肺栓塞或大出血事件。结论对于急性下肢深静脉血栓形成合并Cockett综合征患者,髂静脉支架植入术后的抗凝持续时间可能不是影响支架通畅率的相关因素。Objective To evaluate the therapeutic effect of different anticoagulation duration after stent implantation in patients of deep venous thrombosis combined with Cockett syndrome.Methods The clinical data of 28 patients with acute lower extremity deep venous thrombosis who underwent deep venous catheter thrombolysis combined with iliac vein stent implantation in the Third Affiliated Hospital of Soochow University from September 2016 to May 2020 were analyzed retrospectively.The patients were divided into the short-term anticoagulation group(anticoagulation duration≤90 d)and the prolonged anticoagulation group(anticoagulation duration>90 d)according to the duration of anticoagulation.The stent patency rate,limb circumference difference,Villalta score of the two groups were compared.Results Patients were followed up for an average of(16.8±2.6)months after the operation,and the primary patency rate of the iliac vein stent at 12 months was 96.2%(25/26).One patient had stent occlusion one month after operation,and the Villaalta score was 6 points.There was no significant difference in stent patency rate,limb circumference difference and Villalta score at 12 months after operation between the two groups(P>0.05).One patient in each group had gingival bleeding,and 2 patients in the prolonged anticoagulation group had skin and mucosal hemorrhage,but there was no statistically significant difference in the incidence of bleeding events between the two groups(P>0.05).No symptomatic pulmonary embolism or massive hemorrhage occurred.Conclusion For patients of acute deep vein thrombosis combined with Cockett syndrome,the duration of anticoagulation after iliac vein stent implantation may not be a relevant factor affecting the patency of the stent.

关 键 词：深静脉血栓形成 COCKETT综合征 支架 抗凝 腔内治疗 

分 类 号：R543.6[医药卫生—心血管疾病]