AngioJet吸栓联合髂静脉支架置入术在急性下肢深静脉血栓形成患者治疗中的疗效分析  

The efficacy of AngioJet thrombectomy combined with iliac vein stenting for patients diagnosed with acute lower extremity deep venous thrombosis

作　　者：刘涛[1] 孙波[1] 曹广信[1] 张杰峰[1] 尚遂源 LIU Tao;SUN Bo;CAO Guangxin;ZHANG Jiefeng;SHANG Suiyuan(Department of Vascular Surgery,Weifang People’s Hospital,Weifang,Shandong 261000,P.R.China)

机构地区：[1]潍坊市人民医院血管外科,山东潍坊261000

出　　处：《中国普外基础与临床杂志》2024年第11期1391-1395,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：潍坊市软科学研究计划(项目编号:2021RKX129)。

摘　　要：目的 探讨AngioJet导管吸栓联合髂静脉支架置入治疗急性下肢深静脉血栓形成合并髂静脉受压患者的临床疗效。方法 回顾性分析2021年1月至2023年10月期间潍坊市人民医院血管外科连续收治的行AngioJet导管吸栓联合髂静脉支架置入治疗的64例急性下肢深静脉血栓形成合并髂静脉压迫综合征患者的临床资料,观察手术前后患者的临床症状、体征及血栓负荷量的变化,同时记录静脉及支架通畅度评分、大腿周径差、小腿周径差、静脉临床严重程度评分(venous clinical severity score,VCSS)和慢性静脉功能不全生活质量问卷调查(chronic venous insufficienc questionnaire-14item,CIVIQ-14)评分,术后12个月通过下肢静脉造影观察髂静脉支架通畅程度,综合评估疗效。结果 64例患者手术技术成功率为100%,抽吸时间为300~480 s、(313±32)s,手术时间为80~120 min、(97±21)min;术后均无穿刺点出血、血肿等并发症发生;住院时间5~12 d、(7.5±2.8)d。与术前比较,术后静脉及支架通畅度评分和大腿周径差降低或缩小(P<0.001);VCSS评分降低、CIVIQ-14评分增高(P<0.05)。术后第1、3和6个月彩色多普勒超声检查及第12个月下肢静脉顺行造影检查结果显示,仅1例患者于术后1个月血栓复发,经抗凝保守治疗最终发展为下肢深静脉血栓形成后综合征;其余患者下肢静脉及支架均通畅。结论 AngioJet导管吸栓联合髂静脉支架置入应用于急性下肢深静脉血栓形成合并髂静脉受压患者时,能够快速清除血栓,减轻下肢肿胀,预防静脉血栓后综合征的发生,同时显著提高患者的近远期生活质量。Objective To investigate the clinical efficacy of AngioJet thrombectomy combined with iliac vein stenting for patients diagnosed with acute lower extremity deep venous thrombosis(DVT)with iliac vein compression syndrome(IVCS).Methods Between January 2021 and October 2023,a total of 64 patients with acute lower extremity DVT which performed AngioJet thrombectomy combined with iliac vein stenting in Weifang People’s Hospital were retrospectively analyzed.The changes of clinical symptoms,signs,and thrombus burden before and after operation were observed.The patency score of vein and stent,difference of thigh circumference and calf circumference diameter,venous clinical severity score(VCSS),and chronic venous insufficienc questionnaire-14item(CIVIQ-14)score were recorded preand postsurgically,and the patency of stent was statistically evaluated by a comprehensive assessment of the postoperative 12-month angiography.Results Operative success was achieved in all the 64 patients.The aspiration time was 300–480 s[(313±32)s],and the operative time was 80–120 min[(97±21)min].No complications such as bleeding and hematoma occurred after operation.The hospitalization time was 5–12 d[(7.5±2.8)d].After operation,the patency score of vein and stent and the difference of thigh circumference diameter decreased or reduced,and the difference were statistically significant(P<0.001).The score of VCSS decreased,score of CIVIQ-14 increased after operation(P<0.05).Color Doppler ultrasound was performed at the first,third and sixth months after operation,and anterograde venography of lower limbs was performed at the 12th month. Only one patient had thrombosis recurrence at one month after operation, and finallydeveloped into post-thrombosis syndrome of deep veins of lower limbs after anticoagulant conservative treatment. Theveins and stents of the rest patients were unobstructed. Conclusion AngioJet thrombectomy combined with iliac veinstenting, could effectively expedited clot removal, reduced limb swelling, prevented post-th

关 键 词：深静脉血栓形成 AngioJet吸栓 下腔静脉滤器 髂静脉压迫综合征 

分 类 号：R654.4[医药卫生—外科学]