经大隐静脉入路髂静脉病变的腔内治疗  

Endovascular treatment of iliac vein disease via great saphenous vein approach

作　　者：薛明[1] 官云彪[1] 周亚东[1] 郑学洵 Xue Ming;Guan Yunbiao;Zhou Yadong;Zheng Xuexun(Department of Vascular Surgery,Fujian Medical University Affiliated Union Medical College Hospital,Fuzhou 350000,China)

机构地区：[1]福建医科大学附属协和医院血管外科,福州350000

出　　处：《中华普通外科杂志》2024年第3期203-206,共4页Chinese Journal of General Surgery

摘　　要：目的探讨经大隐静脉入路途径进行髂静脉病变腔内治疗的临床应用价值。方法86例经下肢静脉顺行造影明确非血栓性左髂静脉压迫病变患者,按照入路分为2组,经患肢大隐静脉入路的为A组(46例),经患肢股静脉入路的为B组(40例)。对两组患者穿刺成功率、穿刺置管消耗时间、术后卧床制动情况及治疗期间穿刺处并发症发生率等进行比较。结果A组穿刺成功率为97.8%(45/46);B组穿刺成功率为100%(40/40),两组差异无统计学意义(P>0.05)。A组平均穿刺时间(9.4±2.7)min,B组平均穿刺时间(5.5±1.3)min(P<0.05);A组术后无需制动,B组术后髋关节制动12 h。A组穿刺处的并发症发生率低于B组(P<0.05)。随访复查静脉彩超或造影示髂静脉支架通畅率100%。结论经大隐静脉入路进行髂静脉病变的腔内治疗是一种安全、可行的治疗方法,创伤更小,术后易护理。Objective To investigate the feasibility and clinical value of endovascular treatment of iliac vein disease via the great saphenous vein approach.Methods Eighty-six patients with nonthrombotic left iliac vein compression lesions identified by anterograde lower limb vein angiography were divided into 2 groups:group A(n=46)was treated via great saphenous vein and group B(n=40)was treated via femoral vein.The success rate of puncture,time consuming of puncture catheterization,postoperative bed immobilization and complication rate of puncture were observed and compared between the two groups.Results The puncture success rate was 97.8%(45/46)in group A and 100%(40/40)in group B,there was no significant difference between the two groups(P>0.05).The average puncture time was(9.4±2.7)min in group A and(5.5±1.3)min in group B(P<0.05).The complication rate of group A was lower than that in group B(P<0.05).The patency rate of iliac vein stent was 100%,as indicated by venous color ultrasound or angiography.Conclusion Endovascular treatment of iliac vein disease via great saphenous vein approach is a safe and feasible method with less trauma and easier postoperative care.

关 键 词：隐静脉 放射学 介入性 髂静脉压迫综合征 

分 类 号：R543.6[医药卫生—心血管疾病]