下肢深静脉功能不全与Cockett综合征

Lower extremity deep venous insufficiency and Cockett syndrome.

目的 下肢静脉曲张及下肢深静脉功能不全病人的左髂总静脉 (LCIV)病变的发病情况及其之间的关系 ,以指导临床治疗。方法 连续为 73例 (10 0条患肢 )下肢静脉曲张病人行术前患肢深静脉逆行造影及LCIV造影。结果 (1)LCIV总异常率为 47 9%。在有左侧下肢静脉曲张的病人中有 31例 (5 9 6 % ) ,在只有右侧下肢静脉曲张的病人中 ,仅 4例 (19 4% ) ,两组间的LCIV异常的比率差异有显著意义 (P =0 0 0 17)。LCIV异常包括髂腔静脉交界处压迹、不同程度的狭窄、增宽、充盈缺损和侧支形成。 (2 )下肢深静脉功能不全 6 7条肢体 ,占 6 7 0 %。在左LCIV造影异常的病例中 ,左侧下肢深静脉Ⅲ或Ⅳ级逆流者 14例 ,在左LCIV造影正常的病例中 ,左侧下肢深静脉有Ⅲ或Ⅳ级逆流者仅 6例 ,二者间差异也有显著意义 (P =0 0 2 0 5 )。结论 Cockett综合征可能是左下肢静脉曲张的原因之一 ,同时也是左下肢深静脉功能不全的原因之一。

Objective This study was To investigate the incidence rate of Cockett syndrome and relationship between Cockett syndrome and varicose veins and deep venous incompetence of the left lower extremities.Methods 73 patients(100 legs) with varicose veins of the lower extremities were investigated by descending deep venography and iliography preoperatively.Results There were 35(47 9%) cases with abnormalities of the left common iliac vein (ALCIV)in all the cases.There were 31 cases with this conditions in the patients with varicose veins of the left or both lower extremity.While in the patients with varicose veins of the only right lower extremity,there were only 4 cases with ALCIV.In contrast,there was a significant difference between groups(χ 2=9 8641,P=0 0017).In the patients with ALCIV,14 cases with Ⅲ or Ⅳ grade of deep venous incomptence were found, and only 6 cases with deep venous incompetence in the patients without ALCIV.There was a significant difference(χ 2=5 3688,P=0 0205).Conclusion Cockett's syndrome frequently occurs in varicose veins of the left lower extremity.There is a relationship between them.Cockett's syndrome might be one of the causes for the deep venous incompetence of the left leg.