髂静脉压迫综合征并下肢深静脉血栓的腔内治疗

Curative effect of the endovascular treatment on iliac vein compression syndrome combined with lower extremity deep vein thrombosis

目的探讨综合性腔内治疗髂静脉压迫综合征并下肢深静脉血栓的疗效及安全性。方法回顾分析2014年10月-2016年10月新疆维吾尔自治区人民医院血管外科明确诊断为髂静脉压迫综合征并下肢深静脉血栓的36例患者(左下肢35例,右下肢1例),接受angiojet血栓抽吸、导管溶栓联合球囊扩张及支架植入等综合性腔内治疗。均在下腔静脉滤器保护下行溶栓治疗,其中股青肿2例、使用angiojet血栓抽吸12例(6例联合置管溶栓)、置管溶栓30例、支架植入34例、行单纯髂静脉球囊扩张2例,所有植入支架均为自膨式金属裸支架。结果 36例患者患者均成功实施腔内治疗,患肢肿胀、疼痛均于术后2~3 d内开始消退或减轻。血栓清除Ⅰ级(清除率<50%)5.6%、Ⅱ级(清除率50%~95%)25%、Ⅲ级(清除率>95%)69.44%。治疗期间有1例出现再次肿胀再次实施球囊扩张溶栓治疗后缓解,无大出血及肺栓塞发生。结论综合性腔内治疗髂静脉压迫综合征并下肢深静脉血栓形成疗效显著,是一种安全、恢复时间快、有效的治疗方法。

Objective To investigate the curative effect and safety of the endovascnlar treatment on iliac vein compression syndrome combined with lower extremity deep vein thrombosis;Methods 36 patients undergoing iliac vein compression1 syndrome comt）ined with lower extremity deep vein thrombosis （35 cases of at the left leg and at the Right lower limb 1 case ） treated at department of vascular surgery in people＇s hospital of Xinjiang from 2014 october to 2016 october were retrospectively analyzed, they weare treated by eomprehensive endovascular treatment including angiojet thrombus suction , catheter thrombolysis combined with ballnon expansion and stenting. All cases were given, protection of the inferior vena cava. In , all cases, there were 2 cases who got phlegmasia cerulea, 12 cases given angiojet thrombus suction, and 6 cases among them combined with catheter thrnmbolysis,. There were 30 cases treated with catheter thromholvsis, 34 eases implanted s｜enting, and 2 cases treated with pure iliac venous balloon expansion . All of the stents were bulk type of bare metal stents. Results 36 cases were successfully treated., limb swelling and pain were alleviated within 2 - 3 days, the embolus removal rates are were 5.6% in gradeⅠ ,95% in grade Ⅱ （50% - 95% ） and 69.44% in grade Ⅲ （clearance rate 〉 95% ） ,During treatment one patient appeared swelling again and treated with the second operation, then there were no bleeding and pulmonary embolism ; Conclusion Comprehensive cavity treatment of iliae vein compression syndrome has a good effect and the lower rate ahout extremity deep vein thrombosis. It , is a kind of safe and effective treatment method with quick recovery time.