一期或分期行腔内治疗对下肢深静脉血栓合并髂静脉压迫综合征患者疗效的影响  

Influence of one-stage or staged intracavity therapy on efficacy in patients with low extremity deep venous thrombosis complicated with iliac vein compression syndrome

作　　者：朱威 卢冉[1] 孙浩博 章良 ZHU Wei;LU Ran;SUN Hao-bo;ZHANG Liang(Department of Vascular Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China)

机构地区：[1]蚌埠医学院第一附属医院血管外科,安徽省蚌埠市233004

出　　处：《广西医学》2022年第13期1457-1461,共5页Guangxi Medical Journal

基　　金：安徽省高等学校自然科学研究项目(KJ2019A0327)。

摘　　要：目的 探讨一期或分期行腔内治疗对下肢深静脉血栓(DVT)合并髂静脉压迫综合征(IVCS)患者疗效的影响。方法 回顾性分析63例下肢DVT合并IVCS患者的临床资料,根据治疗方法分为观察组36例与对照组27例。观察组患者采用一期腔内治疗,对照组患者采用分期腔内治疗,术后随访12个月。比较两组患者近中期支架通畅率、血栓复发率、Villalta评分、静脉临床严重程度评分(VCSS)、深静脉血栓后综合征(PTS)发生率、住院费用、住院时间。结果 与对照组比较,观察组住院时间更短、住院费用更少、术后即刻Villalta评分与VCSS下降幅度更大,术后12个月的Villalta评分更低(均P<0.05)。术后随访12个月,两组患者的一期支架通畅率、血栓复发率、深静脉PTS发生率差异均无统计学意义(均P>0.05)。结论 采用一期或分期行腔内治疗均可改善下肢DVT合并IVCS患者的近中期支架通畅率,安全性均较高,但行一期腔内治疗可明显改善患者术后即刻的Villalta评分与支架通畅情况,减少住院时间与住院费用,长期疗效更好。Objective To explore the influence of one-stage or staged intracavity therapy on efficacy in patients with lower extremity deep venous thrombosis(DVT)complicated with iliac vein compression syndrome(IVCS).Methods The clinical data of 63 patients with lower extremity DVT complicated with IVCS were retrospectively analyzed.According to the therapy methods,the patients were assigned to observation group(36 cases)or control group(27 cases).The patients in the observation group were given one-stage intracavity therapy,whereas the control group was employed with intracavity therapy by stages.Both groups were followed up for 12 months.The recent and medium-term patency rate of stent,thrombus recurrence rate,Villalta score,Venous Clinical Severity Scoring(VCSS),incidence rate of deep vein post thrombotic syndrome(PTS),hospitalization expenses,and length of hospital stay were compared between the two groups.Results Compared with the control group,the observation group exhibited a shorter hospital stay,less hospitalization expenses,higher declines of immediately postoperative Villalta score and VCSS,and a lower Villalta score 12 months after operation(all P<0.05).After 12 months of follow-up,there were no statistically significant differences in the one-stage patency rate of stent,thrombus recurrence rate and deep venous PTS incidence rate between the two groups(all P>0.05).Conclusion Employing one-stage or staged intracavity therapy can ameliorate the recent and medium-term patency rate of stent in patients with lower extremity DVT complicated with IVCS,exerting a preferably high safety;however,undergoing one-stage intracavity therapy can significantly ameliorate the immediately postoperative Villalta score and patency of stent,shorten hospital stay and reduce hospitalization expenses,playing a role of a superior long-term efficacy.

关 键 词：下肢深静脉血栓 髂静脉压迫综合征 腔内治疗 球囊扩张 支架植入 治疗时间 疗效 

分 类 号：R658.3[医药卫生—外科学]