支架植入术治疗髂股静脉慢性闭塞的近期临床疗效分析  

Recent clinical effect analysis of stent implantation for chronic iliofemoral vein occlusion

作　　者：朱占弟 孙万里[1] 李安强[1] 牛启兵[1] 温世奇[1] Zhu Zhandi;Sun Wanli;Li Anqiang;Niu Qibing;Wen Shiqi(Department of Vascular Surgery,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃省人民医院血管外科,甘肃兰州730000

出　　处：《血管与腔内血管外科杂志》2024年第12期1468-1471,1486,共5页Journal of Vascular and Endovascular Surgery

基　　金：甘肃省科技计划项目(23JRRA1309);兰州市科技计划项目(2022-05-53)。

摘　　要：目的探讨支架植入术治疗髂股静脉慢性闭塞的近期临床疗效。方法选取2020年1月至2021年12月甘肃省人民医院收治的13例髂静脉合并股静脉慢性闭塞行支架再通术患者,根据术中造影结果行髂静脉支架植入术,术后给予抗凝治疗。观察患者手术前后患肢症状缓解程度,围手术期膝上、膝下15 cm健侧与患侧周径差,评估支架内血流及通畅情况,记录术后相关并发症,比较两组患者视觉模拟评分法(VAS)评分、水肿评分、静脉临床严重程度评分(VCSS)。结果13例髂股静脉慢性闭塞行E+W支架再通术患者手术成功率为100%,手术时间(67.3±9.6)min,住院时间(5.6±1.4)d,住院费用(5.7±0.8)万元。手术前后术髂股静脉慢性闭塞行E+W支架再通术患者血红蛋白水平、尿素水平、尿素水平、血肌酐水平比较,差异均有统计学意义(P﹤0.05)。术后VAS评分、水肿评分及VCSS均低于术前,差异均有统计学意义(P﹤0.05)。术后膝上、膝下15 cm处健侧和患侧周径差均低于术前,差异均有统计学意义(P﹤0.05)。术后3个月、6个月、12个月随访静脉支架内的通畅率分别为96%、93%、93%。所有患者均未发生肾功能不全、穿刺点出血、下肢感觉异常等。结论髂股静脉慢性闭塞患者行E+W支架植入安全、可靠,值得在临床中推广应用。Objective To investigate the short-term clinical effect of stent implantation in the treatment of chronic iliofemoral vein occlusion.Method Thirteen patients with chronic occlusion of iliac vein combined with femoral vein underwent stent recanalization from January 2020 to December 2021 in Gansu Provincial People's Hospital were selected,iliac vein stent implantation was performed according to the intraoperative angiography results,and anticoagulation therapy was given after surgery.The degree of symptom relief of the affected limb before and after surgery,the perioperative diameter difference between the healthy side and the affected side of 15 cm above and below the knee were observed,the blood flow and patency in the stent were evaluated,the postoperative complications were recorded,and the visual analog scale(VAS)score,edema score and venous clinical severity score(VCSS)were compared between the two groups.Result The operation success rate of 13 patients with chronic iliofemoral vein occlusion who underwent E+W stent recalibration was 100%,the operation time was(67.3±9.6)min,the hospital stay was(5.6±1.4)d,and the hospitalization cost was(5.7±0.8)ten thousand yuan.There were statistically significant differences in hemoglobin levels,urea levels,urea levels and serum creatinine levels in patients with chronic iliofemoral vein occlusion undergoing E+W stent recanalization before and after surgery(P<0.05).VAS score,edema score and VCSS after operation were lower than those before operation,and the differences were statistically significant(P<0.05).The difference in circumference between healthy side and affected side at 15 cm above and below the knee after surgery were lower than that before surgery,with statistical significances(P<0.05).The patency rates of venous stents at 3 months,6 months and 12 months were 96%,93%and 93%,respectively.None of the patients had renal insufficiency,bleeding at the puncture point,or paresthesia of lower extremity.Conclusion Iliac and femoral vein in patients with chronic occl

关 键 词：髂股静脉闭塞 支架植入术 静脉支架 腹股沟区 

分 类 号：R543[医药卫生—心血管疾病]