盆腔淤血综合征38例诊断评估和腔内治疗单中心经验  

Diagnosis and evaluation of 38 cases of pelvic congestion syndrome and single center experience in intracavitary treatment

作　　者：冯亚平[1] 张欢[1] 牛鹿原[1] 厉祥涛 罗小云[1] 张福先[1] Feng Yaping;Zhang Huan;Niu Luyuan;Li Xiangtao;Luo Xiaoyun;Zhang Fuxian(Department of Vascular Surgery,Affiliated Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院血管外科,北京100038

出　　处：《中国医师杂志》2023年第5期714-718,共5页Journal of Chinese Physician

基　　金：北京市医院管理中心青年人才培养"青苗"计划(QML20200701)。

摘　　要：目的评价盆腔淤血综合征(PCS)诊断评估流程和腔内治疗的有效性、安全性。方法回顾性分析2019年3月至2022年2月首都医科大学附属北京世纪坛医院收治的38例患者,结合患者症状,经彩色多普勒超声、计算机断层静脉成像(CTV)、静脉造影的流程评估诊断为PCS。用可控弹簧圈加聚多卡醇泡沫硬化剂栓塞卵巢静脉,术后1、3、6个月随访。结果38例患者总手术成功率100%,并发症发生率5.3%(2/38);弹簧圈植入数(2.8±0.3)个/人;硬化剂用量(7.0±2.1)ml/人。患者症状改善率97.4%(37/38);术后1、3、6个月复查彩色多普勒超声,栓塞卵巢静脉均无再通;宫旁静脉直径(2.8±0.5)mm,较术前的(7.5±1.9)mm明显降低(P<0.05);VAS评分(2.12±1.87)分,较术前的(7.58±0.82)分明显降低(P<0.001)。结论流程化评估有助于发现、确诊亟须治疗的PCS患者;可控弹簧圈加泡沫硬化剂栓塞卵巢静脉为主的腔内治疗,微创、安全、有效。Objective To evaluate the diagnostic evaluation process and the effectiveness and safety of intracavitary therapy for pelvic congestion syndrome(PCS).Methods A retrospective analysis was conducted on 38 patients admitted to Beijing Shijitan Hospital affiliated to Capital Medical University from March 2019 to February 2022.Combined with the patient′s symptoms,PCS was diagnosed by color Doppler ultrasound,computed tomography venography(CTV),and venography.The ovarian vein was embolized with controllable spring coil and polydocanol foam sclerosing agent.The patients were followed up 1,3 and 6 months after operation.Results The total surgical success rate of 38 patients was 100%,and the incidence of complications was 5.3%(2/38);Spring coils(2.8±0.3)per person;The dosage of hardener was(7.0±2.1)ml/person.The improvement rate of patient symptoms was 97.4%(37/38);After 1,3,and 6 months of surgery,color Doppler ultrasound was reexamined and no recanalization was observed in the embolized ovarian veins;The diameter of the parauterine vein was(2.8±0.5)mm,which was significantly lower than the preoperative(7.5±1.9)mm(P<0.05);The Visual Analogue Scale(VAS)score was significantly lower than the preoperative score[(2.12±1.87)points vs(7.58±0.82)points,P<0.001].Conclusions Process based assessment is helpful in identifying and diagnosing PCS patients who urgently need treatment;Endovascular treatment based on embolization of ovarian vein with controllable spring coil and foam sclerosing agent is minimally invasive,safe and effective.

关 键 词：盆腔淤血综合征 卵巢静脉 腔内治疗 超声检查 多普勒 彩色 

分 类 号：R713[医药卫生—妇产科学]