早期小球囊辅助治疗髂静脉压迫并急性下肢深静脉血栓

Early Balloon-assisted Treatment for Cockett Syndrome Complicated by Lower Extremity Deep Venous Thrombosis

目的分析早期小球囊辅助治疗髂静脉压迫综合征(cockett syndrome,CS)并急性下肢深静脉血栓(lower extremity deep vein thrombosis,LEDVT)的安全及可行性。方法对比分析2016年1月至2017年3月收治的46例髂静脉压迫并LEDVT患者经2种方案(试验组:溶栓前预先给予小球囊扩张髂静脉受压段;对照组:未行预先球囊扩张)置管溶栓+经皮髂静脉腔内血管成形术的相关数据[2组治疗前后肢体的周径变化、静脉通畅评分及静脉通畅率、并发症发生情况、深静脉血栓后遗症(post-thrombosis syndrome,PTS)发生情况、尿激酶使用总量及溶栓时间]。结果所有患者症状均得到改善,试验组的溶栓周期短、尿激酶用量少、并发症发生率较对照组低(均P<0.05),2组治疗前后患肢周径差、静脉通畅率、静脉通畅度评分、有症状性肺栓塞及PTS发生率比较差异无统计学意义(均P>0.05)。结论预先小球囊扩张对治疗髂静脉压迫并LEDVT治疗效果明确,可以缩短治疗周期,降低溶栓药量,减少溶栓并发症的发生概率。

Objective To evaluate the safety and feasibility of early balloon-assisted treatment for Cockett syndrome(CS) complicated by lower extremity deep venous thrombosis(LEDVT). Methods The data of 46 patients treated in our hospital between January 2016 and March 2017 for CS complicated by LEDVT were analyzed.These patients received balloon dilation in the compressed iliac vein(experiment group) or not(control group) before catheter thrombolysis and percutaneous intravascular angioplasty were performed.The limb circumference,venous patency rate and score,incidences of complications and PTS,urokinase dosage,and thrombolysis time were compared between the two groups. Results All patients achieved remission.Compared with control group,thrombolysis time was shortened and urokinase dosage and complications were reduced in experiment group( P <0.05).There were no significant differences between the two groups in limb circumference,venous patency rate and score,and incidences of symptomatic pulmonary embolism and PTS( P >0.05). Conclusion The early balloon-assisted treatment can shorten treatment duration and decrease the dosage of thrombolytic drugs and incidence of complications in patients with CS complicated by LEDVT.