血管内治疗不同侧别非血栓性髂静脉压迫综合征的临床疗效比较  

Comparison of the clinical effect of endovascular therapy on treating left-and right-side non-thrombotic iliac vein compression syndrome

作　　者：徐耀 卢冉[1] 余朝文[1] 聂中林[1] Xu Yao;Lu Ran;Yu Chaowen;Nie Zhonglin(Department of Vascular Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院血管外科,蚌埠233004

出　　处：《中华解剖与临床杂志》2023年第11期736-741,共6页Chinese Journal of Anatomy and Clinics

摘　　要：目的对比分析血管内治疗不同侧别非血栓性髂静脉压迫综合征(NIVCS)的临床疗效和治疗特点。方法回顾性队列研究。纳入2015年6月—2021年6月蚌埠医学院第一附属医院血管外科NIVCS患者60例,其中男29例、女31例,年龄29~74(51.4±11.8)岁。按照病变部位的侧别不同分为2组,左侧NIVCS 30例纳入L组、右侧NIVCS 30例纳入R组,2组均接受血管内治疗。对比2组患者基线资料;观察比较2组患者术后症状改善情况,以及支架置入患者的球囊直径和长度、支架直径和长度等围术期指标;评估患者术前及术后12个月的静脉临床严重程度评分(VCSS);术后第6、12个月对支架置入患者行下肢深静脉彩超或下肢顺行静脉造影检查,观察髂静脉支架术后6个月和术后1年通畅率,以及与支架相关的并发症。结果2组NIVCS患者性别构成、年龄、身高、体质量、体质量指数、下肢慢性静脉性疾病临床-病因-解剖-病理生理学分类系统(CEAP)分级等基线资料比较,差异均无统计学意义(P值均>0.05)。2组60例患者手术均顺利完成,其中18例行单纯球囊扩张成形术,42例接受球囊扩张联合支架置入治疗。2组患者的球囊直径、球囊长度、术前髂静脉狭窄率、术后1小时髂静脉狭窄率比较,差异均无统计学意义(P值均>0.05);L组和R组患者术后1 h髂静脉狭窄率[4.0(3.0,6.0)、4.5(3.0,6.0)]均低于术前[95.0(89.8,98.0)、95.0(90.0,96.0)],组内差异均有统计学意义(Z=-4.79、-4.79,P值均<0.001)。L组球囊直径为(13.4±1.5)mm,大于R组的(12.3±1.4)mm,差异有统计学意义(t=2.85,P值<0.05);L组支架长度为(60.0±8.9)mm,小于R组的(79.1±13.4)mm,差异有统计学意义(t=-5.42,P值<0.05)。术后随访10~14(12.7±0.9)个月,2组60例患者临床症状均得以改善或完全恢复正常,L组术后第12个月有1例下肢深静脉血栓形成。L组和R组术前VCSS评分分别为12.5(11.0,13.3)分和12.0(11.0,13.0)分,术后第12个月VCSS评分分�Objective This study aims to investigate the clinical efficacy and treatment characteristics of endovascular therapy in the treatment of left-and right-side iliac vein compression syndrome.Methods A retrospective cohort study was conducted.A total of 60 patients aged 29-74(51.4±11.8)years,with non-thrombotic iliac vein compression syndrome(NIVCS),in the department of vascular surgery of the First Affiliated Hospital of Bengbu Medical College from June 2015 to June 2021 were included,including 29 males and 31 females.They were divided into two groups in accordance with the lesion side.Among them,30 patients with left NIVCS were included in the L group,and 30 patients with right NIVCS were included in the R group.All patients received endovascular interventional therapy.The baseline data of the two groups were compared,and the improvement of their postoperative symptoms was observed.The perioperative indices,such as balloon diameter,balloon length,stent diameter,and stent length,of the two groups were also compared.The preoperative and 12-month postoperative venous clinical severity scores(VCSSs)were evaluated.Lower-limb deep-vein ultrasonography or anterograde venography was performed in patients with stent implantation at 6 and 12 months after surgery to observe the venous and stent blood flow,stent-related complications,and iliac vein patency rate.Results No significant difference was observed in the baseline data,such as gender,age,height,body mass,body mass index(BMI),and the clinical‑etiology‑anatomy‑pathophysiology classification system grading of chronic venous diseases of the lower extremities,between the two groups(all P values>0.05).The operation of the two groups was successfully completed,of which 18 patients underwent simple balloon dilation,and 42 received balloon dilation combined with stent implantation.The postoperative follow-up time was 10−14(12.7±0.9)months,and the clinical symptoms of all patients improved or completely returned to normal.One patient in the L group had lower-extremit

关 键 词：髂静脉 血管内治疗 非血栓性髂静脉压迫综合征 支架 球囊 

分 类 号：R654.4[医药卫生—外科学]