左下肢深静脉血栓形成合并髂静脉压迫综合征不同治疗方式疗效分析  

Efficacy of different treatment modalities for left lower extremity deep vein thrombosis combined with iliac vein compression syndrome

作　　者：翟刚 李静静 索飞飞 庞宏永[1] 田珂[1] ZHAI Gang;LI Jingjing;SUO Feifei;PANG Hongyong;TIAN Ke(Vascular Surgery,Shangqiu First People's Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第一人民医院血管外科,河南商丘476000

出　　处：《中国医学工程》2023年第10期91-95,共5页China Medical Engineering

摘　　要：目的分析不同治疗方案在左下肢深静脉血栓形成(DVT)合并髂静脉压迫综合征(IVCS)患者治疗中的应用优势,为治疗方式的选择提供理论依据。方法选择2019年1月至2021年12月商丘市第一人民医院60例左下肢DVT合并IVCS患者为研究对象,根据治疗方法分为一站式组31例和分期组29例。一站式组采用一站式腔内治疗,分期组采用分期腔内治疗。比较两组血栓清除效果、手术相关指标、手术前后患肢周径差、静脉临床严重程度评分(VCSS)、维拉尔塔量表(Villalta)评分,随访1年记录支架通畅率、血栓复发率和深静脉血栓后综合征(PTS)发生率。结果分期组血栓清除效果优于一站式组,住院时间、治疗费用均多于一站式组(P<0.05);术后一站式组大腿周径差、小腿周径差大于分期组(P<0.05);术后两组VCSS、Villalta评分较术前减小,且一站式组高于分期组(P<0.05);随访1年两组支架通畅率、血栓复发率、PTS发生率比较差异无统计学意义(P>0.05)。结论一站式腔内治疗与分期腔内治疗应用于左下肢DVT合并IVCS均有较好安全性,分期腔内治疗可增强血栓清除效果,而一站式腔内治疗可促进病情恢复,缩短术后恢复时间,减轻患者经济负担。【Objective】To analyze the advantages of different treatment options in the treatment of patients with left lower extremity deep vein thrombosis(DVT)combined with iliac vein compression syndrome(IVCS),and to provide a theoretical basis for the choice of treatment modality.【Methods】Sixty patients with left lower extremity DVT combined with IVCS in Shangqiu First People's Hospital from January 2019 to December 2021 were selected for the study,and were divided into 31 cases in the onestop group and 29 cases in the staging group according to the treatment method.The one-stop group was treated with one-stop intracavitary therapy and the staged group was treated with staged intracavitary therapy.The hematoma clearance effect,surgeryrelated indexes,the circumference difference of the affected limb before and after surgery,Venous Clinical Severity Score(VCSS),and Villalta scale score were compared between the two groups,and the stent patency rate,thrombosis recurrence rate,and post-deep vein thrombosis syndrome(PTS)incidence were recorded at 1 year follow-up.【Results】The staging group had better thrombus clearance than the one-stop group,and had more hospitalization time and treatment cost than the one-stop group(P<0.05);the postoperative thigh circumference difference and calf circumference difference were greater in the one-stop group than in the staging group(P<0.05).Postoperatively,the VCSS score and Villalta score decreased in the two groups compared with those before surgery,and the one-stop group was higher than the staging group(P<0.05);there was no significant difference in the stent patency rate,thrombosis recurrence rate,and post-thrombotic syndrome rate between the two groups at 1 year of follow-up(P>0.05).【Conclusion】One-stop endoluminal therapy and staged endoluminal therapy both have better safety when applied to DVT combined with IVCS in the left lower extremity.Staged endoluminal therapy can enhance thrombus removal,while one-stop endoluminal therapy can reduce the economic burden of patie

关 键 词：深静脉血栓形成 髂静脉压迫综合征 支架通畅率 血栓复发 静脉临床严重程度 

分 类 号：R654.3[医药卫生—外科学]