腔内血管成形术治疗髂静脉压迫综合征患者的临床疗效及影响因素分析

Clinical efficacy and influencing factors of transluminal angioplasty in the treatment of patients with iliac venous compression syndrome

目的探讨腔内血管成形术治疗髂静脉压迫综合征(IVCS)患者的临床疗效,并分析影响治疗效果的影响因素。方法收集2015年8月至2019年8月承德市中心医院收治的124例IVCS患者的临床资料。依据治疗方式不同分为球囊扩张组(n=56)和血管成形术组(n=68),球囊扩张组患者接受球囊扩张治疗,血管成形术组患者接受腔内血管成形术治疗。采用视觉模拟评分法(VAS)评估两组患者的疼痛程度;术后12个月,评估两组患者的预后情况和临床疗效;腔内血管成形术治疗IVCS患者临床疗效的影响因素采用Logistic回归分析。结果术后1、3、6个月,两组患者的VAS评分均低于本组术前,且血管成形术组患者术后1、3个月的VAS评分均低于球囊扩张组患者,差异均有统计学意义(P<0.05)。随访12个月,血管成形术组患者水肿缓解率、溃疡愈合率均高于球囊扩张组患者,髂静脉再狭窄率低于球囊扩张组患者,差异均有统计学意义(P<0.05)。血管成形术组患者的治疗总有效率为64.71%,高于球囊扩张组患者的46.43%,差异有统计学意义(P<0.05)。Logistic回归分析显示,IVCS类型为腰椎退变相关型、栓塞范围累及腘静脉、血栓密度越高、病程越长是影响腔内血管成形术治疗IVCS患者临床疗效的危险因素(P<0.05)。结论腔内血管成形术治疗IVCS是一种安全、有效的手术方法,其中IVCS类型、栓塞范围、血栓密度及病程可影响治疗效果。

Objective To explore the clinical efficacy of transluminal angioplasty in treatment of patients with iliac venous compression syndrome(IVCS),and analyze the factors influencing the treatment effect.Method The clinical data of 124 patients with IVCS in Chengde Central Hospital from August 2015 to August 2019 were collected.They were divided into balloon dilatation group(n=56,treated with balloon dilatation therapy)and angioplasty group(n=68,treated with transluminal angioplasty)according to different treatment methods.The visual analogue scoring(VAS)was used to evaluate the grade of pain in the two group;the prognosis and clinical efficacy of the two groups were evaluated 12 months after the operation;the factors influencing clinical efficacy of transluminal angioplasty for IVCS patients were analyzed by Logistic regression.Result At 1,3,and 6 months after surgery,the VAS scores of the two groups were lower than those of the preoperative group,and the VAS scores of the patients in the angioplasty group were lower than those in the balloon dilatation group at 1,3 months after surgery,and the differences were statistically significant(P<0.05).Follow-up for 12 months,the edema relief rate and ulcer healing rate of the angioplasty group were higher than those of the balloon dilatation group,and the iliac vein restenosis rate was lower than that of the balloon dilatation group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the angioplasty group was 64.71%,which was higher than 46.43%in the balloon dilatation group,and the difference was statistically significant(P<0.05).Logistic regression showed that the lumbar degeneration related type of IVCS,the popliteal vein involvement,higher thrombus density and longer course of disease are risk factors of the factors influencing clinical efficacy of transluminal angioplasty for IVCS patients(P<0.05).Conclusion Transluminal angioplasty is a safe and effective surgical method for IVCS,in which the type of IVCS,embolization range,thrombus density and disease course can affect the treatment effect.