先天性下腔静脉畸形10例临床诊断及治疗研究

Clinical diagnosis and treatment of 10 cases of congenital inferior vena cava malformation

目的分析先天性下腔静脉畸形(IVCM)的临床特点及意义.方法收集2013年至2018年我院收治10例IVCM患者的临床资料,分析其临床表现,诊断和治疗方法.结果10例中双下腔静脉畸形(DIVC)2例,左位下腔静脉(LIVC)3例,LIVC合并DIVC 1例,下腔静脉缺如(IVCA)1例,LIVC+IVCA(近心段)1例,折返型下腔静脉(RIVC)1例,线型IVC 1例.合并下肢静脉血栓(DVT)6例,误诊为布加综合征(BCS)3例,合并下肢深静脉瓣膜功能不全(DVI)1例.结论 IVCM临床罕见,因缺乏特异性表现易被忽视,但却是多种疾病尤其是静脉血栓性疾病的重要危险因素,其在腹部、盆腔及腹膜后手术中和血管介入性治疗中有着重要临床意义,忽略其存在可能导致严重的后果.

Objective To analyze the clinical characteristics and significance of congenital inferior vena cava malformation (IVCM). Methods The clinical data of IVCM from 2013 to 2018 were studied. The clinical manifestations, diagnostic methods and characteristics were analyzed. Results There were 2 cases of double inferior vena cava ( DI VC), 3 cases of LIVC, 1 case of LIVC + DIVC, 1 case of IVCA, 1 case of LIVC + IVCA near cardiac segment, 1 case of reentrant inferior vena cava ( RIVC) and 1 case of linear inferior vena cava (IVC). Among them, 6 cases were complicated with DVT, 3 cases were misdiagnosed as budd-chiari syndrome ( BCS), and 1 case was complicated with severe deep venous insufficient (DVI). Conclusion IVCM is rare and often ignored because of nonspecific manifestations, but it is an important risk factor for many diseases. It has important clinical significance in abdominal, pelvic and retroperitoneal surgery and vascular interventional therapy. Neglecting may lead to serious consequences.