超声消融治疗下肢深静脉血栓形成及术后并发腹股沟部淋巴瘘原因探讨  

Causes of groin lymphatic fistula after transluminal ultrasonic angioplasty in the treatment of deep vein thrombosis of lower extremity

作　　者：周兴立[1] 陈翠菊[1] 郭曙光[1] 尹存平[1] 

机构地区：[1]成都军区昆明总医院血管外科,云南昆明650032

出　　处：《中国普通外科杂志》2004年第1期9-11,共3页China Journal of General Surgery

摘　　要：目的　探讨下肢深静脉血栓形成 (DVT )经腹股沟部位切口行腔内超声消融取栓手术的效果及术后并发切口淋巴液渗出 (淋巴瘘 )的原因。方法　对 72例下肢DVT患者经腹股沟部位切口 ,行超声血栓消融术及术后并发切口淋巴瘘 (60例 )的临床资料进行回顾性分析。结果　 72例超声消融、球囊取栓均获成功。其中 51例髂总静脉汇入下腔静脉处存在狭窄 ,经球囊扩张后狭窄消失 ,其中 6例置入支架。术后并发腹股沟部位淋巴瘘 60例。无手术死亡。平均随访 3个月 (1～ 2 1个月 ) ,全部患者症状消失 ,仅 5例肢体周径较对侧粗 0 .5～ 1.5cm。结论　该治疗方法治疗下肢深静脉血栓疗效满意 ,但术后淋巴瘘发生率高 ,其原因与淋巴管损伤、静脉高压致淋巴液增多、感染。ObjectiveTo investigate the causes of groin lymphatic fistula after transluminal ultrason ic angioplasty (TUA) in the treatment of deep vein thrombosis(DVT) of lower extremity through groin incision. Methods A retrospective anal ysis of the causes of groin lymphatic fistula(GLF) in 72 patients with DVT after treatment of ultrasonic ablation was made. ResultsTUA and thr ombectomy using Forgaty balloon catheter for DVT of lower extremity achieved successful recanalization in all the 72 cases (100%). Of the 72 cases,51 had i liac vein stenosis,the venous stenosis disappeared after balloon dilation;amo ng the 51 cases ,6 cases received stent placement. GLF occurred postoperati vely in 60 cases. No death occurred in this series. ConclusionsTUA is an effective method in the treatment of DVT of lower extremity,but t he incidence of postoperative GLF is high.The causes of GLF may be related to the injury of lymphatic vessels, increase of quantity of lymph flow induced by increased venous pressure, infection, surgical technique factors and postop erative medicine therapy etc.

关 键 词：血栓性静脉炎 外科学 超声消融术 副作用 淋巴瘘 病因学 

分 类 号：R714.625[医药卫生—妇产科学]