下肢股蓝肿12例诊治分析

Diagnosis and treatment of phlegmasia cerulea dolens:a report of 12 cases

目的:总结股蓝肿(phlegmasia cerulea dolens,PCD)的诊治经验,探讨最佳诊治方案。方法:12例PCD患者,4例行左股静脉切开取栓术,2例行下腔静脉永久性滤器植入+左股静脉切开取栓术,5例行下腔静脉永久性滤器植入+左股静脉切开取栓术+左髂静脉球囊扩张术。1例予以抗凝、溶栓等保守治疗。结果:11例手术均成功,未发生与手术、抗凝、溶栓等有关的严重并发症,无肺栓塞、截肢、死亡发生。另1例保守治疗者,第2天足背动脉可触及,第8天接近正常。结论:股静脉切开取栓联合及时、有效、足量的抗凝是治疗PCD经济、有效、安全的方法。

Objective：To summarize the experience intreatment of phlegmasia cerulea dolens（PCD）and to explore the optimal therapy.Methods：The clinical data of 12 cases of PCD were retrospectively analyzed,11 cases were treated surgically,the surgical procedures included simple thrombectomy in 4 limbs,inferior vena cava filter placement＋thrombectomy in 2 limbs,inferior vena cava filter placement ＋thrombectomy＋left iliac vein balloon angioplasty in 5 limbs.Only one patient received anticoagulation and thrombolysis.Results：All surgery in 11 cases were sucessful,no severe postoperative complications occurred,all the patients were cured of their symptoms,there was pulmonary embolism,amputation or death.The pulsation of dorsal artery was found overnight,and the limb was almost normal after 8 days in anther patient receiving conventional treatment.Conclusions：Thrombectomy combined prompt and full dosage of anticoagulation is safe,effective,and economical for treatment of PCD.