介入治疗用于髂静脉压迫综合征合并深静脉血栓形成的临床价值和疗效评价  

Clinical value and efficacy evaluation of interventional therapy in patients with iliac vein compression syndrome complicated with deep venous thrombosis

作　　者：李荣华[1] 杨植[1] 武慧娟 王树艳[3] 张弘[1] 尹晶 司景元 唐维红 LI Rong-hua;YANG Zhi;WU Hui-juan(Vascular Surgery,the Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China;Department of Cardiac Electrophysiologic,the Affiliated Hospital of Chengde Medical College,Chengde Hebei 067000,China)

机构地区：[1]承德医学院附属医院血管外科,河北承德067000 [2]承德医学院附属医院心脏电生理科,河北承德067000 [3]承德医学院附属医院介入手术室,河北承德067000 [4]江苏省无锡市第六人民医院血管介入科,江苏无锡214000 [5]承德医学院附属医院手术室,河北承德067000 [6]重庆市大足区人民医院急诊科,重庆402360

出　　处：《临床和实验医学杂志》2022年第16期1740-1743,共4页Journal of Clinical and Experimental Medicine

基　　金：承德市科学技术研究与发展计划基金资助项目(编号:201706A033);河北省医学科学研究重点课题基金资助项目(编号:20170877)。

摘　　要：目的 探讨介入治疗用于髂静脉压迫综合征(IVCS)合并深静脉血栓形成(DVT)患者的临床疗效及临床表现严重程度评分(VCSS)对疗效评估的应用价值。方法 回顾性分析2019年8月至2020年8月承德医学院附属医院血管外科收治的144例IVCS合并DVT患者的临床资料。所有患者均接受介入治疗,治疗后均进行12个月的随访。收集患者随访期间静脉造影结果,记录患者术前及术后3、6、12个月时VCSS和血栓形成后综合征(PTS)分级情况;采用Spearman等级相关系数分析VCSS评分与PTS分级的相关关系;采用受试者工作特征(ROC)曲线分析VCSS对PTS的预测价值。结果 患者术后大腿周径差、小腿周径差及髂静脉狭窄率为(1.84±0.72) cm、(1.58±0.47) cm、(18.55±6.03)%,均显著低于术前[(3.67±1.12) cm、(2.81±0.54) cm、(76.50±11.83)%],差异均有统计学意义(P<0.05)。术前以及术后3、6、12个月时VCSS评分分别为(9.31±1.19)、(2.46±0.85)、(1.83±0.57)、(0.91±0.35)分。与术前相比,患者术后3、6、12个月时VCSS评分均明显降低,差异均有统计学意义(P<0.05)。术后3、6、12个月时VCSS评分与PTS分级均呈正相关(P<0.05)。术前VCSS评分判断术后PTS风险的ROC曲线下面积(AUC)为0.777(95%CI:0.594~0.960,P=0.018),敏感度为0.750,特异度为0.714。结论 介入治疗在IVCS合并DVT中的疗效确切,患者VCSS评分与PTS分级有一定相关性,有助于评估IVCS合并DVT治疗效果。Objective To investigate the clinical efficacy of interventional therapy in patients with iliac vein compression syndrome(IVCS)complicated with deep venous thrombosis(DVT)and the value of venous clinical severity score(VCSS)in evaluating the efficacy.Methods The clinical data of 144 patients with IVCS with DVT in the Department of Vascular Surgery of the Affiliated Hospital of Chengde Medical College from August 2019 to August 2020 were retrospectively analyzed.All patients received interventional therapy and were followed up for 12 months after treatment.The results of venography during follow-up were collected.The VCSS and the grading of post thrombotic syndrome(PTS)were recorded before operation,3,6 and 12 months after operation,the correlation between VCSS score and PTS score at different time points were analyzed.The predictive value of VCSS for PTS was analyzed using receiver-operator(ROC)curves.Results The postoperative thigh circumference difference,leg circumference difference and iliac vein stenosis rate were(1.84±0.72)cm,(1.58±0.47)cm,(18.55±6.03)%,which were significantly lower than those before operation[(3.67±1.12)cm,(2.81±0.54)cm,(76.50±11.83)%],the difference were statistically significant(P<0.05).The VCSS scores were(9.31±1.19),(2.46±0.85),(1.83±0.57),and(0.91±0.35)scores before operation,at 3 months after operation,at 6 months after operation,and at 12 months after operation.Compared with before operation,the VCSS scores were significantly lower than those at 3,6 and 12 months after operation,the difference were statistically significant(P<0.05).The VCSS scores at 3,6,and 12 months after operation were positive correlated with the PTS(P<0.05).The ROC analysis showed that the AUC of preoperative VCSS score to judge the risk of postoperative PTS was 0.777(95%CI:0.594-0.960,P=0.018),the sensitivity was 0.750 and the specificity was 0.714.Conclusion The interventional therapy is effective in IVCS combined with DVT.There is a certain correlation between VCSs score and PTS grade,it helpful t

关 键 词：髂静脉压迫综合征 临床表现严重程度评分 深静脉血栓 血栓形成综合征 

分 类 号：R543.6[医药卫生—心血管疾病]