非血栓性髂静脉受压程度与静脉曲张临床分级的相关性

Correlation Between Compression Degree of Nonthrombotic Iliac Vein and Clinical Grading of Varicose Vein

目的探讨髂静脉受压程度与静脉曲张临床分级的相关性。方法回顾性分析苏北人民医院2016年9月-2017年9月103例下肢慢性静脉功能不全(CVI)患者的临床资料,根据CEAP分级法将患者静脉曲张程度分为C1~C6级,均于16排螺旋CT扫描下行下肢静脉造影,评估髂静脉受压程度,比较不同性别患者的髂静脉受压程度,分析髂静脉受压程度与年龄、性别、髂静脉侧枝形成、静脉曲张程度间的相关性。结果不同性别患者的左髂静脉平均受压程度比较,差异无统计学意义(P>0.05);左髂静脉受压的程度与髂静脉侧枝形成显著相关(AUROC=0.657,P<0.05),与患者静脉曲张程度、年龄、性别不相关(P>0.05);静脉曲张程度与性别、年龄、侧支形成不相关(P>0.05);髂静脉侧枝形成与年龄、性别不相关(P>0.05)。结论髂静脉受压综合症病因复杂,其与下肢静脉曲张临床分级无明显相关性。髂静脉侧枝循环的形成在一定程度上可以改善下肢静脉回流,缓解临床症状,故对于有大量盆腔侧枝形成的髂静脉受压综合症患者应结合影像学及临床表现,制定更为合理的治疗方案。

Objective To investigate the correlation between the degree of iliac vein compression and the clinical grading of varicose veins.Methods The clinical data of 103 patients with chronic venous insufficiency(CVI)of the lower extremities from September 2016 to September 2017 in Subei People's Hospital were retrospectively analyzed.The degree of varicose veins was divided into C1-C6 grades according to the CEAP classification method.Lower extremity venography was performed under 16-slice spiral CT scan to evaluate the degree of iliac vein compression.The degree of iliac vein compression in patients of different genders was compared,and the correlation between the degree of iliac vein compression and age,gender,iliac vein collateral formation and varicose vein degree was analyzed.Results There was no significant difference in the average compression degree of left iliac vein between different genders(P>0.05).The degree of left iliac vein compression was significantly correlated with the formation of iliac vein collateral branches(AUROC=0.657,P<0.05),was not correlated with the degree of varicose veins,age and gender(P>0.05).The degree of varicose veins was not correlated with gender,age and collateral formation(P>0.05).The formation of iliac vein collateral branch was not correlated with age and gender(P>0.05).Conclusion The etiology of iliac vein compression syndrome is complex,and it has no significant correlation with clinical grading of varicose veins of lower extremities.The formation of iliac vein collateral circulation can improve the venous reflux of lower limbs and alleviate clinical symptoms to a certain extent.Therefore,for patients with iliac vein compression syndrome with a large number of pelvic collaterals,a more reasonable treatment plan should be formulated combined with imaging and clinical manifestations.