临床研究(Clinical Research)

腔内综合治疗髂股静脉血栓形成

Published at: 2016年第25卷第6期

尹孝亮 1 , 高涌 1 , 聂中林 1 , 陈世远 1 , 唐文波 1
1 蚌埠医学院第一附属医院 血管外科,安徽 蚌埠 233004
通讯作者 涌 高 Email: Dr.gaoyong@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.06.019
基金:

摘要

目的:探讨腔内治疗急性髂股静脉血栓形成的临床疗效。方法:回顾性分析2013年1月―2015年1月64例行腔内综合治疗的急性髂股静脉血栓形成患者临床资料。结果:患者经下腔静脉滤器保护下置管溶栓术治疗后,新鲜血栓均得到有效溶解,无严重溶栓并发症发生;13例(13/64)患者发现髂静脉狭窄严重,下肢肿胀缓解不明显,同期行球囊扩张,其中5例(5/64)二期造影发现侧支血管代偿不佳、髂静脉狭窄>50%,行二期支架植入。经腔内综合治疗,患者的双下肢膝上15 cm周径差较术前明显缩小(3.87 cm vs. 7.56 cm,P<0.05);随访期间无再发下肢肿胀、髂股静脉狭窄及支架内血栓形成,无下肢色素沉着及溃疡形成,无肺动脉栓塞及死亡病例。结论:腔内综合治疗急性髂股静脉血栓形成安全、有效,对清除血栓、解除狭窄实现管腔再通效果良好。


Endovascular treatment of iliofemoral venous thrombosis

Abstract

Objective: To investigate the clinical efficacy of endovascular treatment for acute iliofemoral vein thrombosis. Methods: The clinical data of 64 patients with acute iliofemoral venous thrombosis undergoing integrated endovascular therapy from January 2013 to January 2015 were retrospectively analyzed. Results: Fresh thrombus was all effectively dissolved in all patients after the treatment of catheter-directed thrombolysis with inferior vena cava filter insertion, without serious thrombolysis-related complications; 13 patients (13/64) underwent simultaneous balloon dilation due to severe iliac vein stenosis and no evident improvement of the lower limb swelling, of whom 5 cases (5/64) with a poor collateral circulation and iliac vein stenosis greater than 50% as shown by subsequent venography were subjected to second-stage stent implantation. After the integrated endovascular therapy, the postoperative circumference difference between two legs at 15 cm above the knee joint was significantly reduced compared with the preoperative value (3.87 cm vs. 7.56 cm, P<0.05). During the period of follow-up, no lower limb swelling and iliofemoral stenosis recurrence as well as intra-stent thrombosis were noted, and no lower limb pigmentation , ulcer formation, pulmonary embolism or death occurred. Conclusion: Integrated endovascular therapy of the iliac femoral vein is safe and effective for acute iliofemoral venous thrombosis. It can achieve good effect on the removal of thrombus and recanalization.


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引用

引用本文: 孝亮 尹, 涌 高, 中林 聂, 世远 陈, 文波 唐. 腔内综合治疗髂股静脉血栓形成[J]. 中国普通外科杂志, 2016, 25(6): 887-891.
Cite this article as: YIN Xiaoliang, GAO Yong, NIE Zhonglin, CHEN Shiyuan, TANG Wenbo . Endovascular treatment of iliofemoral venous thrombosis [J]. Chin J Gen Surg, 2016, 25(6): 887-891.