4例髂股血管外膜囊肿的临床分析

Clinical analysis of 4 cases with adventitial cystic disease in the iliofemoral vessels

目的探讨髂股血管外膜囊肿的临床特征、治疗及预后。方法回顾性分析2017年3月至2019年6月济宁医学院附属医院血管外科诊治的4例髂股血管外膜囊肿患者的临床资料。男性2例,女性2例;年龄54~82岁,中位年龄61岁。分析其就诊资料和临床特点。结果3例患者为股总静脉外膜囊肿,均表现为下肢肿胀。1例为髂股动脉外膜囊肿,表现为下肢间歇性跛行。彩超均提示腹股沟区囊性占位,邻近血管受压。2例患者接受病变切除+人工血管重建术,1例接受囊肿切除术,1例股静脉支架植入术,手术成功率100%。4例患者全部获得随访,随访时间8~36个月,中位时间21个月,临床症状均较术前改善,无复发征象。结论当患者短期内出现进展性的下肢跛行或肿胀时,须警惕下肢血管外膜囊肿的可能。外科手术是保证治疗后通畅率的主要方法,但要根据患者的情况选择具体的手术方式。

Objective To investigate the clinical characterization,treatment and prognosis of adventitial cystic disease in the iliofemoral vessels.Methods The clinical data of 4 patients with adventitial cystic disease in the iliofemoral vessels from Department of Vascular Surgery,Affiliated Hospital of Jining Medical University between March 2017 and June 2019 were analyzed retrospectively.There were 2 males and 2 females with age of 61 years old(from 54 to 82 years old).We analyzed their medical information and clinical characteristics.Results Three patients had adventitial cystic disease in the common femoral vein,all of which showed swelling of the lower extremities.One case occurred in the iliofemoral artery,which showed intermittent claudication of the lower extremity.All patients showed cystic space in the groin area,and adjacent blood vessels were compressed by color Doppler ultrasound.Two patients underwent cystectomy and bypass,one patient underwent cystectomy,and one patient underwent stent placement in common femoral vein.The operation success rate was 100%,and one case had a wound infection.Patients were followed up for 8~36 months,with a median time of 22.3 months.The clinical symptoms improved,and there were no signs of recurrence.Conclusion Clinicians should be vigilant when patients have progressive claudication or swelling in the lower extremity.The patency rate of open surgery is the main method to maintain the patency rate after treatment,but it needs to be selected according to the specific situation of the patient.