血栓抽吸术联合髂静脉支架植入术治疗下肢深静脉血栓合并髂静脉压迫综合征的临床疗效及安全性  

Clinical efficacy and safety of thrombus aspiration combined with iliac vein stent implantation in the treatment of lower extremity deep vein thrombosis combined with iliac vein compression syndrome

作　　者：邱建林 张玉珍 冯学强 路新玉 Qiu Jianlin;Zhang Yuzhen;Feng Xueqiang;Lu Xinyu(Department of Vascular Intervention Surgery,Affiliated Hospital of Shandong Second Medical University,Weifang 261021,Shandong,China)

机构地区：[1]山东第二医科大学附属医院血管介入外科,山东潍坊261021

出　　处：《血管与腔内血管外科杂志》2025年第2期237-240,256,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨采用血栓抽吸术联合髂静脉支架植入术治疗下肢深静脉血栓(DVT)合并髂静脉压迫综合征(IVCS)的临床疗效及安全性。方法收集2023年1月至2024年4月山东第二医科大学附属医院收治的30例下肢DVT合并IVCS患者的临床资料,所有患者均行血栓抽吸术联合髂静脉支架植入治疗,统计患者的预后情况。结果所有患者均顺利完成治疗,液体抽吸量为180~290 ml,平均(225±31)ml;抽吸血栓时间为5~21 min,平均(11.4±5.7)min;技术成功率为100%;血栓清除分级为Ⅲ级。30例患者中,7例患者的髂静脉狭窄率﹥50%,均植入1枚支架,平均尿激酶用量为(80±10)万U,无患者出现血红蛋白尿;与术前相比,术后患者C反应蛋白(CRP)、白细胞介素-6(IL-6)以及D-二聚体(D-D)水平均下降,差异均有统计学意义(P﹤0.05);与术前相比,术后大腿、小腿患侧与健侧周径差以及脚踝围差均减小,差异均有统计学意义(P﹤0.05)。术后随访3~6个月,血管支架通畅率为100%。结论对于下肢DVT合并IVCS患者,通过血栓抽吸术联合髂静脉支架植入治疗可以保障血管通畅,改善患者临床症状,是一种安全、有效的治疗方法。Objective To investigate the clinical efficacy and safety of using thrombus aspiration combined with iliac vein stent implantation in the treatment of lower extremity deep vein thrombosis(DVT)combined with iliac vein compression syndrome(IVCS).Method The clinical data of 30 cases patients with lower extremity DVT combined with IVCS admitted to the Affiliated Hospital of Shandong Second Medical University from January 2023 to April 2024 were collected.All patients underwent thrombus aspiration combined with iliac vein stent implantation treatment,and the prognosis of the patient were statistically analyzed.Result All patients successfully completed the treatment,the fluid suction volume was 180-290 ml,the average was(225±31)ml;the thrombectomy time was 5-21 min,the average was(11.4±5.7)min;the technical success rate was 100%,and the thrombectomy clearance grading was Ⅲ.Among the 30 patients,7 patients with iliac vein stenosis rate>50%were implanted and all had one stent implanted.The average dosage of urokinase was(80±10)million U,and no patient had hemoglobinuria.The levels of C-reactive protein(CRP),interleukin-6(IL-6)and D-dimer(D-D)in postoperative patients were decreased compared with those before surgery,and the differences were statistically significant(P<0.05).Compared with the preoperative results,the postoperative diameter difference and ankle circumference difference were smaller,and the differences were statistically significant(P<0.05).At the same time,after 3-6 months of follow-up,the patency rate of vascular stent was 100%.Conclusion For patients with lower extremity DVT combined with IVCS,the combination of thrombus aspiration and iliac vein stent treatment can maintain vascular patency,improve patient symptoms,and is a safe and effective treatment method.

关 键 词：髂静脉压迫综合征 血栓抽吸 下肢深静脉血栓 

分 类 号：R543[医药卫生—心血管疾病]