左右侧髂静脉压迫综合征支架置入术后疗效观察:单中心回顾性研究  

Clinical therapeutic effect of left and right iliac vein compression syndrome after stenting:a single center retrospective study

作　　者：黎万华 王哲[1] 赵渝[1] LI Wanhua;WANG Zhe;ZHAO Yu(Department of Vascular Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,P.R.China)

机构地区：[1]重庆医科大学附属第一医院血管外科,重庆400016

出　　处：《中国普外基础与临床杂志》2023年第3期327-332,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的对比左、右侧非血栓性髂静脉压迫综合征(non-thrombotic iliac vein compression syndrome,NIVCS)患者血管内支架治疗后的临床症状改善情况及支架通畅情况。方法回顾性收集2016年1月至2021年1月期间重庆医科大学附属第一医院收治的NIVCS患者的临床资料,分析患者术前及术后第12个月时的静脉临床严重程度评分(venous clinical severity score,VCSS),同时分析术后第1、3、6及12个月时患者支架通畅情况。结果本研究共收集164例NIVCS患者,其中左侧144例、右侧20例。血管腔内手术技术成功率100%(164/164)。左、右侧NIVCS患者术后第12个月时VCSS比较差异无统计学意义(t=1.265、P=0.208),发现无论是左侧还是右侧NIVCS患者在术后第12个月时VCSS均较术前下降(t=27.534、P<0.001,t=10.047、P<0.001)。左、右侧NIVCS患者术后12个月的累积一期通畅率分别为96.5%和94.7%,二者Kaplan-Meier曲线比较差异无统计学意义(χ2=0.160,P=0.689)。在支架充分支撑并彻底覆盖病变范围后,髂静脉受压部位及置入支架的类型、直径及长度对于支架的短期通畅率(1年内)无明显影响(P>0.05)。结论从本研究结果看,无论是左侧还是右侧NIVCS,采用支架置入治疗效果相近且均安全、有效。Objective To compare the improvement of clinical symptoms and patency of stents in patients with left and right non-thrombotic iliac vein compression syndrome(NIVCS)after endovascular stent therapy.Methods The clinical data of patients with NIVCS admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to January 2021 were analyzed retrospectively.The venous clinical severity score of the patients’veins before therapy and on month 12 after therapy was analyzed.At the same time,the patencies of stents on month 1,3,6,and 12 after stenting were also analyzed.Results A total of 164 patients with NIVCS were collected,including 144 left NIVCS and 20 right NIVCS.The surgical technique success rate of endovascular stent therapy was 100%(164/164).There was no statistical difference of the venous clinical severity score between the patients with left and right NIVCS on month 12 after therapy(t=1.265,P=0.208),but the venous clinical severity score of left and right NIVCS patients on month 12 after therapy were lower than those before therapy(t=27.534,P<0.001;t=10.047,P<0.001).The accumulative one-stage stent patency rate on month 12 after therapy was 96.5%and 94.7%in the patients with left and right NIVCS,respectively(χ2=0.160,P=0.689).After the stent was fully supported and completely covered the extent of the lesion,the short-term(within 12 months)stent patency rates of the patients with different compression site of the iliac vein,as well as type,diameter,and length of stent placement had no statistical differences(P>0.05).Conclusion From the results of this study,whether left NIVCS or right NIVCS,endovascular stent therapy is safe and effective.

关 键 词：非血栓性髂静脉压迫综合征 临床症状 腔内支架治疗 通畅 

分 类 号：R654.4[医药卫生—外科学]