血管内支架治疗髂股静脉血栓形成后综合征的疗效分析

The efficacy of endovascular stent in the treatment of iliofemoral post-thrombosis syndrome

目的:探讨血管内支架治疗髂股静脉血栓形成后综合征(PTS)的临床疗效。方法:回顾性分析27例髂股静脉PTS病人的病例资料,静脉再通后置入支架,随访半年,采用Villalta评分和慢性静脉功能不全问卷(CIVIQ-20)评价治疗前后PTS的严重程度和生活质量。结果:全部病人术后即刻静脉均成功再通;随访半年后,一期通畅率、辅助通畅率和二期通畅率分别为66.7%(18/27)、77.8%(21/27)和88.9%(24/27)。Villalta评分从术前的(17.44±5.49)分,在随访半年后降到(5.78±3.31)分(P<0.01),CIVIQ-20评分从(37.26±10.89)分升至(58.93±12.91)分(P<0.01),术后半年随访严重程度明显低于术前(P<0.01);logistic回归分析显示,术前Villalta和CIVIQ-20评分、年龄是Villalta增益相关的独立影响因素(P<0.05~P<0.01),术前Villalta评分是CIVIQ-20增益相关的独立影响因素(P<0.05)。结论:血管内支架对髂股静脉PTS的治疗有效,能降低PTS的严重程度,改善病人的生活质量。

Objective:To investigate the clinical effects of endovascular stent in the treatment of iliofemoral post-thrombosis syndrome(PTS).Methods:The clinical data of 27 patients with iliofemoral PTS were analyzed retrospectively.After venous recanaliztion and self-expandable stenting,the patients were followed up for 6 months.The severity of PTS and quality of life before and after treatment were evaluated using Villalta score and chronic venous insufficiency questionnaire(CIVIQ-20)scale.Results:All patients were successfully recanalized after operation.After 6 months fo following-up,the primary patency rate,assisted patency rate and secondary patency rate were 66.7%(18/27),77.8%(21/27)and 88.9%(24/27),respectively.The Villalta score decreased from(17.44±5.49)before operation to(5.78±3.31)after operation(P<0.01),while the CIVIQ-20 scores increased from(37.26±10.89)to(58.93±12.91)(P<0.01).The severity of postoperative half-year follow-up was significantly lower than that before surgery(P<0.01).The results of logistic regression analysis showed that the preoperative Villalta and CIVIQ-20 scores,and age were the independent factors related to the Villalta gain,and the preoperative Villalta was the independent factors related to the CIVIQ-20 gain.Conclusions:The endovascular stent in the treatment of iliofemoral PTS is effective,which can reduce the severity of PTS and improve the quality of life.