下肢静脉性溃疡合并髂静脉压迫综合征的两种术式评估

Evaluation of Two Surgical Methods for Lower Limb Venous Ulcers Combined with Iliac Vein Compression Syndrome

目的探讨两种术式治疗下肢静脉性溃疡合并髂静脉压迫综合征的临床疗效。方法选取2019年1月—2022年6月本院收治的30例下肢静脉性溃疡合并髂静脉压迫综合征患者为研究对象,随机分为对照组和研究组,每组15例。对照组行单纯髂静脉腔内成形术,研究组行髂静脉腔内成形术联合Trivex旋切术治疗,出院后第1个月、3个月、6个月、12个月进行随访,记录并收集每次随访两组患者的髂静脉支架通畅、溃疡愈合、肿胀缓解、CEAP分级变化以及溃疡复发等情况。结果研究组的溃疡愈合、肿胀缓解、CEAP分级变化、溃疡复发均优于对照组,差异有统计学意义(P<0.05)。两组患者髂静脉支架通畅情况差异无统计学意义(P>0.05)。结论应用髂静脉腔内成形术联合Trivex旋切术治疗下肢静脉性溃疡合并髂静脉压迫综合征患者,疗效更为显著,安全性有保障,值得临床推广应用。

Objective To explore clinical effect of two surgical methods in treatment of lower limb venous ulcers combined with iliac vein compression syndrome.Methods The paper chose 30 patients with lower limb venous ulcers complicated with iliac vein compression syndrome admitted to our hospital from January 2019 to June 2022,and divided them into control group and study group randomly,with 15 cases in each group.Control group was treated with simple iliac vein luminal reconstruction,while study group with iliac vein luminal reconstruction combined with Trivex circumcision.Follow ups were carried out at 1,3,6,and 12 months after discharge,iliac vein stent patency,ulcer healing,swelling relief,CEAP grading changes,and ulcer recurrence were recorded and collected between two groups for each follow-up.Results Ulcer healing,swelling relief,CEAP grading changes,and ulcer recurrence in study group were better than control group,with statistically significant difference(P<0.05).There was no statistically significant difference in patency of iliac vein stent between two groups(P>0.05).Conclusion Iliac vein endoplasty combined with Trivex circumcision can achieve significant curative effect and guaranteed safety for patients with lower limb venous ulcers complicated with iliac vein compression syndrome,which is worthy of clinical promotion and application.