髂静脉压迫综合征合并单纯下肢静脉曲张的疗效分析

Efficacy analysis of iliac vein compression syndrome with lower extremity varicose veins

目的探讨髂静脉压迫综合征合并单纯下肢静脉曲张的临床疗效及其安全性。方法回顾性分析2012年8月~2014年8月在本院收治的首次治疗的髂静脉压迫综合征合并单纯下肢静脉曲张67例患者的临床及随访资料,分为两组,其中39例患者接受腔内介入治疗加浅表曲张静脉激光治疗（介入加激光治疗组）,28例接受单纯血管腔内介入治疗（单纯介入治疗组）。主要随访观察指标包括髂静脉通畅率、肿胀缓解、静脉溃疡愈合及并发症情况。结果所有患者髂静脉通畅率为94.03%,静脉溃疡治愈率为77.61%,肿胀缓解率79.10%,疼痛缓解率64.18%;两组髂静脉通畅率差异无统计学意义（χ~2=0.118,P〉0.05）,两组患者的浅表静脉溃疡愈合率差异有统计学意义（χ2=7.905,P〈0.05）,并发症共发生支架内血栓形成4例,深静脉血栓形成7例,皮肤、胃肠道黏膜出血5例,均给予相应治疗后好转。结论血管腔内介入治疗髂静脉压迫综合征具有较好的治疗效果,并发症少,在介入治疗的基础上进行激光术治疗浅静脉曲张,患者的临床症状缓解更明显,值得作为临床的一种治疗方法。

Objective To investigate the clinical curative effect and safety of iliac vein compression syndrome combined simple varicose veins of lower limbs. Methods The clinical data of 67 patients with iliac vein compression syndrome with lower extremity varicose veins from August 2012 to August 2014 were retrospectively analyzed. Of the patients, 39 cases underwent endovascular interventional procedure and endovascular laser ablation（EVLA） spontaneously（intervention and laser treatment group）, and 28 cases received pure endovascular interventional procedure（pure endovascular interventional group）. Main follow-up observation indexes including iliac venous patency rate, swelling, alleviate, venous ulcer healing and complication. Results Both of the rates of iliac vein patency were 94.03%. There were patients with venous ulcer cure rate and swelling of the remission rate and pain relief rate were 77.61%, 79.10% and64.18%. There was no statistically significant difference of iliac venous patency rate between two groups（χ~2=0.118, P〈0.05）. But the difference was statistically significant of the superficial venous ulcer healing rate（χ~2=7.905, P〈0.05）.Stent thrombosis occurred in 4 cases, deep vein thrombosis in 7 cases, 5 cases of skin and gastrointestinal mucous membrane hemorrhage, all gave corresponding improvement after treatment. Conclusion Endovascular interventional procedure treatment of iliac vein compression syndrome have very good treatment effects, fewer complications, on the basis of interventional therapy for the treatment of laser light varicose veins, the patients＇ clinical symptoms more apparent, it deserved as an new treatment of clinical.