介入治疗急性下肢深静脉血栓形成合并骼静脉压迫综合征的疗效及安全性分析

Efficacy and Safety of Interventional Therapy for Acute Lower Extremity Deep Vein Thrombosis Complicated with Iliac Vein Compression Syndrome

目的探究介入治疗急性下肢深静脉血栓形成(deep venous thrombosis,DVT)合并骼静脉压迫综合征的有效性及安全性。方法回顾性分析2018年4月-2020年2月沛县人民医院收治的急性DVT合并骼静脉压迫综合征60例患者的临床资料,比较患者治疗前后肢体周径差,统计分析治疗前后患者静脉血流速度、血管内径、抗凝血酶水平及血小板计数水平的差异,观察患者治疗后相关并发症情况。采用Villalta量表评分来评估患者血栓后综合征患病率。在术后12个月的时间内对患者随访复查,评估患者的治疗效果。结果患者的介入手术成功率为100.00%,治疗后大腿周径差(2.64±0.33)cm及小腿周径差(1.63±0.25)cm均显著小于治疗前,差异有统计学意义(t=22.670、87.137,P<0.05);治疗后,静脉血流速度较治疗前显著提高,差异有统计学意义(t=-22.039,P<0.05),抗凝血酶水平及血小板计数水平均显著降低,差异有统计学意义(P<0.05);未观察到患者大出血或30 d死亡情况;3、6和12个月的骼静脉通畅率分别为100.00%、98.33%、95.00%;Villalta评分显示,仅有1例患者出现轻度血栓后综合征,无患者出现重度血栓后综合征;住院期间未观察到有肺栓塞症状、髂静脉破裂的患者。结论介入治疗对于急性DVT合并骼静脉压迫综合征患者具有较好的疗效,且安全性良好。

Objective To explore the efficacy and safety of interventional therapy for acute lower extremity deep vein thrombosis(DVP)complicated with iliac vein compression syndrome.Methods The clinical data of 60 patients with acute DVP complicated with iliac vein compression syndrome admitted to Peixian,Jiangsu Province from April 2018 to February 2020 were retrospectively analyzed.The limb circumference difference before and after treatment was compared,and the differences in venous blood flow velocity,vessel diameter,antithrombin level and platelet count level were statistically analyzed before and after treatment,and the related complications after treatment were observed.The Villalta scale was used to assess the prevalence of post-thrombotic syndrome in patients.The patients were followed up for reexamination within 12 months after the operation to evaluate the treatment effect of the pa⁃tients.Results The success rate of interventional surgery was 100.00%,after treatment,the difference in thigh cir⁃cumference(2.64±0.33)cm and the difference in calf circumference(1.63±0.25)cm were significantly smaller than those before treatment,the difference was statistically significant(t=22.670,87.137,P<0.05);after treatment,the venous blood flow velocity was significantly increased,the difference was statistically significant(t=-22.039,P<0.05);and the level of antithrombin and platelet count were significantly decreased,the difference was statistically significant(P<0.05);no major bleeding or 30 d death was observed in the patient;the patency rates of the iliac vein at 3 months,6 months and 12 months were 100.00%,98.33%and 95.00%,respectively.According to the Villalta score,only 1 patient had mild post-thrombotic syndrome,and no patients had severe post-thrombotic syndrome;no patients with symptoms of pulmonary embolism and iliac vein rupture were observed during hospitalization.Conclusion Interventional therapy has good curative effect and good safety in patients with acute DVT complicated with iliac vein compression syndrome.