非血栓性髂静脉狭窄支架成形术对深静脉瓣膜功能的影响

Effect of Non-thrombotic Iliac Vein Stenosis on Deep Venous Valve Function

目的探讨髂静脉支架成形术对非血栓性髂静脉压迫病变(NIVCL)患者深静脉瓣膜功能的影响。方法收集2015年4月～2018年4月我院血管外科22例行髂静脉支架成形术治疗的NIVCL合并下肢深静脉瓣膜反流患者的临床资料及随访结果,其中21例左侧髂静脉狭窄,1例右侧髂静脉狭窄,比较患者手术前后深静脉瓣膜反流持续时间(VCT)及静脉疾病严重程度评分(VCSS)。结果 22例患者手术均成功,成功率100.00%,术后无支架闭塞、下肢感染和深静脉血栓形成等严重并发症。术后3个月随访时,一期支架通畅率100.00%,肿胀缓解率83.30%,溃疡愈合率80.00%。患者术后3个月VCT较术前减少[(1.68±1.67)s vs(2.46±1.36)s],差异有统计学意义(P<0.05);术后3个月VCSS评分较术前降低[(5.00±1.54)分vs(5.59±2.13)分],差异有统计学意义(P<0.05)。结论髂静脉支架成形术是NIVCL安全、有效的治疗方法,对轻度深静脉瓣膜功能不全有明显改善作用。

Objective To investigate the effect of iliac vein stenting on deep venous valve function in patients with non-thrombotic iliac vein compression(NIVCL).Methods From April 2015 to April 2018,22 patients with vascular surgery in our hospital underwent iliac vein stenting for clinical data and follow-up of NIVCL with deep venous valve regurgitation.21 patients had left iliac vein stenosis.One patient had a right iliac vein stenosis.The duration of deep venous regurgitation(VCT)and venous disease severity score(VCSS)were compared before and after surgery.Results All the 22 patients were successfully operated with a success rate of 100.00%.There were no serious complications such as stent occlusion,lower limb infection and deep vein thrombosis.At 3 months follow-up,the first-stage stent patency rate was 100.00%,the swelling relief rate was 83.30%,and the ulcer healing rate was 80.00%.The VCT of the patients decreased 3 months after operation[(1.68±1.67)s vs(2.46±1.36)s],the difference was statistically significant(P<0.05);the VCSS score decreased 3 months after surgery[(5.00±1.54)score vs(5.59±2.13)score],the difference was statistically significant(P<0.05).Conclusion The iliac vein stenting is a safe and effective treatment for NIVCL,which has a significant improvement on mild deep venous insufficiency.