髂静脉压迫综合征的诊断与治疗  

Diagnosis and treatment of Iliac vein compression syndrome

作　　者：张伟[1] 刘洪[1] 赵渝[1] ZHANG Wei;LIU Hong;ZHAO Yu(Department of Vascular Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,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：《中国实用外科杂志》2023年第12期1429-1431,1435,共4页Chinese Journal of Practical Surgery

基　　金：重庆市科卫联合医学科研项目(No.2022MSXM077)。

摘　　要：髂静脉压迫综合征(IVCS)是近年来关注度较高的外周静脉疾病,临床上可分为无症状型、慢性静脉功能不全型和急性髂股静脉血栓型3种类型。IVCS的诊断主要依赖于影像学检查,常用的影像学检查方法有彩色多普勒超声(CDU)、腔内超声(IVUS)、数字减影血管造影(DSA)、计算机断层扫描静脉成像(CTV)和磁共振静脉成像(MRV)等,其中超声、CTV和MRV等影像学检查在IVCS的诊断中起非常重要的作用。应根据具体情况选择合适的检查方式。IVCS的治疗方法主要包括保守治疗和手术治疗,其中手术治疗以球囊扩张和支架植入为主要方式,可有效解除髂静脉流出梗阻,缓解慢性静脉功能不全症状,预防深静脉血栓形成。手术治疗的指征、支架的选择和术后管理等方面仍存在一些争议,需要进一步开展临床研究并形成共识。Iliac vein compression syndrome(IVCS)has gained significant attention as a peripheral venous disease in recent years.Clinically it can be classified into three types:asymptomatic chronic venous insufficiency and acute iliofemoral venous thrombosis.The diagnosis of IVCS primarily relies on imaging examinations with commonly used methods including color Doppler ultrasound(CDU) intravascular ultrasound(IVUS) digital subtraction angiography(DSA) computed tomography venography(CTV) and magnetic resonance venography(MRV).Among these ultrasound CTV and MRV play crucial roles in the diagnosis of IVCS.The choice of appropriate diagnostic methods should be based on specific situations.Treatment methods for IVCS mainly include conservative and surgical approaches.Surgical treatment primarily involving balloon dilation and stent implantation effectively relieves iliac vein outflow obstruction alleviates symptoms of chronic venous insufficiency and prevents deep vein thrombosis formation.There are still some controversies regarding the indications for surgical treatment stent selection and postoperative management necessitating further clinical research and consensus formation.

关 键 词：髂静脉压迫综合征 影像学检查 球囊扩张 支架植入 

分 类 号：R6[医药卫生—外科学]