介入溶栓治疗LIVCS并发LDVT患者的效果及安全性研究  

Efficacy and safety of interventional thrombolysis in the treatment of patients with left iliac vein compression syndrome complicated with left lower limb deep vein thrombosis

作　　者：王辉[1] 李诗城 岳江 卢翔[1] 郭岚 刘锐 WANG Hui;LI Shi-cheng;YUE Jiang;LU Xiang;GUO Lan;LIU Rui(Department of Interventional and Vascular Surgery,Department of Nail and Breast Surgery,Hanzhong 723000,Shaanxi,CHINA;Department of Interventional and Vascular Surgery,Department of Ultrasound Medicine,Hanzhong 723000,Shaanxi,CHINA;Department of Interventional and Vascular Surgery,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,CHINA)

机构地区：[1]陕西省汉中市中心医院介入与血管外科,陕西汉中723000 [2]陕西省汉中市中心医院甲乳外科,陕西汉中723000 [3]陕西省汉中市中心医院超声医学科,陕西汉中723000

出　　处：《海南医学》2023年第22期3233-3236,共4页Hainan Medical Journal

基　　金：陕西省自然科学基础研究计划项目(编号:2018JQ8057)。

摘　　要：目的研究介入溶栓治疗左髂静脉受压综合征(LIVCS)并发左下肢深静脉血栓形成(LDVT)患者的效果及安全性。方法选择2020年1月至2023年1月汉中市中心医院收治的90例LIVCS并发LDVT患者作为研究对象,按照随机数表法将患者分为观察组和对照组各45例。对照组患者给予外周静脉溶栓治疗,观察组患者给予介入溶栓治疗。均治疗1周后,比较两组患者的临床疗效、治疗前后的患侧与健侧大小腿周径差、血流速度、受压处血管内径、血栓清除率,并统计两组患者的并发症发生率。结果治疗后,观察组患者的治疗总有效率为97.78%,明显高于对照组的80.00%,差异有统计学意义(P<0.0.5);治疗后,两组患者的患侧与健侧大、小腿周径差均明显降低,且观察组患者患侧与健侧大腿和小腿周径差分别为(1.88±0.43)cm、(1.84±0.36)cm,明显低于对照组的(2.67±0.58)cm、(2.71±0.67)cm,差异均有统计学意义(P<0.05);观察组患者受压处血管内径、血栓清除率分别为(4.57±0.33)mm、(66.74±2.52)%,高于对照组的(4.16±0.23)mm、(61.42±2.31)%,血流速度为(60.18±7.17)cm/s,明显低于对照组的(66.26±7.26)cm/s,差异均有统计学意义(P<0.05);治疗后,观察组患者的并发症发生率为8.89%,明显低于对照组的24.44%,差异有统计学意义(P<0.05)。结论介入溶栓治疗LIVCS并发LDVT疗效确切,可有效改善患者下肢肿胀情况,调节血管狭窄闭塞,降低血栓水平,且并发症发生率低,安全可靠。Objective To explore the efficacy and safety of interventional thrombolysis in the treatment of left iliac vein compression syndrome(LIVCS)complicated with left lower limb deep vein thrombosis(LDVT).Methods Ninety patients with LIVCS complicated with LDVT admitted to Hanzhong Central Hospital from January 2020 to January 2023 were selected as the study subjects,which were randomly divided into an observation group and a control group,each with 45 cases.Patients in the control group were treated with peripheral venous thrombolysis,while those in the observation group were treated with interventional thrombolysis.After one week of treatment,clinical efficacy,the difference in leg circumference,blood flow velocity,vascular diameter at the compression site,and thrombus clearance rate between the affected and healthy sides of the two groups of patients were compared before and after treatment,and the incidence of complications in the two groups was counted.Results After treatment,the total effective rate of the observation group was 97.78%,which was significantly higher than 80.00%in the control group(P<0.05).After treatment,the difference in circumference between the affected and healthy sides of the thigh and calf in the observation group were(1.88±0.43)cm and(1.84±0.36)cm,which were significantly lower than(2.67±0.58)cm and(2.71±0.67)cm in the control group(P<0.05).The blood vessel diameter and thrombus clearance rate at the compression site in the observation group were(4.57±0.33)mm and(66.74±2.52)%,which were significantly higher than(4.16±0.23)mm and(61.42±2.31)%in the control group;the blood flow velocity was(60.18±7.17)cm/s,which was significantly lower than(66.26±7.26)cm/s in the control group;the differences were statistically significant(P<0.05).After treatment,the incidence of complications in the observation group was 8.89%,which was significantly lower than 24.44%in the control group(P<0.05).Conclusion Interventional thrombolysis for the treatment of LIVCS complicated with LDVT has a definite t

关 键 词：左髂静脉受压综合征 左下肢深静脉血栓形成 血栓 介入溶栓 并发症 

分 类 号：R442.8[医药卫生—诊断学]