球囊扩张术联合支架成形术治疗髂静脉压迫综合征患者临床观察

Clinical observation of stenting on vascular patency and venous reflux in patients with iliac vein compression syndrome

目的髂静脉受压综合征是临床常见解剖学变异类型,其发生与后侧腰椎及前侧脐动脉压迫有关,其发病率较高,对患者造成严重影响。本研究分析球囊扩张术与球囊扩张术联合支架成形术对髂静脉受压综合征患者血管通畅率及静脉反流的影响,以寻求最佳的治疗方案。方法选取2014-07-13-2016-06-12本院收治的118例髂静脉受压综合征患者为研究对象,在患者知情同意前提下,按照组间性别、年龄、病灶部位匹配的原则分为两组,各59例。对照组行球囊扩张术,观察组行球囊扩张术联合支架成形术,对比两组临床疗效、血管通畅率、临床症状改善情况及生活质量。结果观察组治疗总有效率为94.92%,高于对照组的83.05%,χ2=4.236,P=0.040。随访3年,观察组血管通畅率为93.22%,高于对照组的79.66%,χ2=4.628,P=0.032;术后,观察组疼痛、溃疡、水肿、浅静脉反流症状发生率分别为18.64%、1.69%、22.03%和8.47%,均低于对照组的35.59%、13.56%、62.71%和50.85%,差异有统计学意义,均P<0.05。观察组术后CIVIQ评分为(4.82±1.94)分,低于对照组的(13.37±2.36)分,差异有统计学意义,t=21.497,P<0.001。结论支架成形术用于髂静脉受压综合征患者的治疗可有效提升临床疗效,提升血管通畅率,改善患者临床症状,提升其生命质量。

OBJECTIVE Iliac vein compression syndrome(IVCS)is a common clinical anatomical variant,which is related to posterior lumbar vertebrae and anterior umbilical artery compression.The incidence of IVCS is high,and it has a serious impact on patients.This study analyzes the effects of balloon dilatation and balloon dilatation combined with stenting on vascular patency and venous reflux in patients with iliac vein compression syndrome in order to find the best treatment.METHODS Totally 118patients with iliac vein compression syndrome admitted to our hospital from July 13,2014 to June 12,2016were selected as the research subjects.With informed consent of the patients,they were divided into two groups according to the principle of matching gender,age and lesion location,with 59cases in each group.The control group underwent balloon dilatation and the observation group underwent balloon dilatation combined with stenting.The clinical efficacy,vascular patency rate,improvement of clinical symptoms and quality of life were compared between the two groups.RESULTS The total effective rate of the observation group was 94.92%,which was higher than that of the control group(83.05%,χ2=4.236,P=0.040).After 3years of follow-up,the vascular patency rate of the observation group was 93.22%,which was higher than that of the control group(79.66%,χ2=4.628,P=0.032).After operation,the incidence of pain,ulcer,edema and superficial venous reflux in the observation group was 18.64%,1.69%,22.03%and 8.47%,which were lower than those of the control group(35.59%,13.56%,62.71%and 50.85%),the differences were statistically significant,Pall<0.05.The postoperative CIVIQ score was(4.82±1.94)in the observation group,which was lower than that in the control group(13.37±2.36).The difference was statistically significant,t=21.497,P<0.001.CONCLUSION Stent angioplasty in the treatment of patients with iliac vein compression syndrome can effectively improve the clinical efficacy,vascular patency,improve the clinical symptoms of patients,and improve their quality of life.