髂静脉受压综合征的诊治

Diagnosis and treatment of iliac vein compression syndrome

髂静脉受压综合征的发生有其解剖学因素 ,症状及体征无特征性。诊断主要靠静脉造影、静脉压力测定、血管内超声检查、多谱勒超声检查、磁共振静脉成像及CT等检查。在急性髂股静脉血栓形成前 ,主要采用保守治疗以防止血栓形成。手术治疗主要以解除梗阻 ,使髂静脉血流通畅为目的 ;腔内血管重建有取代外科手术的趋势。髂静脉受压综合征如在发生髂股静脉血栓之前及时诊断 ,了解髂静脉狭窄程度、血液流变学及血流动力学特点 ,并适时地纠正和治疗 。

The occurrence of iliac vein compression syndrome(IVCS) has the anatomic factor.IVCS has no specific symptoms and signs.The diagnosis of IVCS is mainly made by venography, intravascular pressure measurement, intravascular ultrasound, Doppler ultrasound,magnetic resonance venography, and CT.Before the occurrence of acute iliofemoral thrombosis,the treatment of IVCS is conservative therapy.The purpose of surgical intervention is to resolve the obstruction and keep the blood flow. The surgery of occluded iliac veins secondary to IVCS is now to be replaced by endovascular reconstruction. IVCS can be treated correctly before the occurrence of iliofemoral thrombosis and its sequelae can be reduced greatly, if the diagnosis of IVCS can be made as early as possible,and the degree of the stenosis of the iliac vein,the characteristics of its hemorheology and hemodynamics can be understood in time.