髂静脉支架植入术治疗Cockett综合征合并下肢深静脉血栓形成患者的中期效果分析

Analysis of mid-term effects of iliac vein stents for patients with Cockett's syndrome combined with deep vein thrombosis of lower extremities

目的探讨髂静脉支架应用于Cockett综合征合并下肢深静脉血栓形成(deep vein thrombosis,DVT)患者的中期效果。方法回顾性分析海南省人民医院2012年1月至2018年12月收治的386例Cockett综合征合并DVT患者的临床资料,按导管接触性溶栓是否接受髂静脉支架植入而分为支架组(213例)和对照组(173例),比较并发症、血栓形成后综合征(post-thrombotic syndrome,PTS)发生率和生活质量CIVID-2评分。结果支架组术后12个月的累积一期通畅率为76.5%,一期辅助通畅率为79.1%,二期通畅率为84.7%,术后12个月瓣膜反流(P=0.013)和下肢DVT复发的发生率均低于对照组(P=0.037)。支架组的术后12个月和24个月的PTS发生率均低于对照组(12个月:P=0.026;24个月:P=0.014),生活质量均优于对照组(12个月:P=0.033;24个月:P=0.006)。结论髂静脉支架治疗Cockett综合征合并DVT安全性高,瓣膜反流发生率低,支架通畅率高等优点,且能降低中期的PTS发生率,改善生活质量。

Objective To explore the mid-term effects of iliac vein stents for patients with Cockett's syndrome combined with deep vein thrombosis(DVT)of lower extremities.Methods The clinical data of 386 patients of Cockett's syndrome with DVT at Hainan General Hospital from January 2012 to December 2018 were analyzed retrospectively.Patients were divided into stent group(213 cases)and control group(173 cases)according to whether iliac vein stent were performed after catheter-contact thrombolysis,and the incidence of complications,post-thrombotic syndrome(PTS)and quality of life score(CIVID-2)were compared between the two groups.Results The overall primary,assisted primary,and secondary patency rate of the stent group at 12 months after surgery were 76.5%,79.1%and 84.7%,respectively.The incidence of valve regurgitation(P=0.013)and DVT recurrence(P=0.037)in the stent group were lower than those in the control group at 12 months.The incidence of PTS at 12 months and 24 months after surgery in the stent group was lower than that in the control group(P=0.026 and 0.014,respectively),and the quality of life was better than the control group(P=0.033 and 0.006,respectively).Conclusion The iliac vein stent in the treatment of Cockett's syndrome combined with DVT is safety,with low incidence of valvular regurgitation and high stent patency rate.It can reduce the incidence of mid-term PTS and improve the quality of life.