腔内综合治疗对少数民族地区Cockett综合征伴左下肢深静脉血栓形成老龄患者的效果分析

Effect of endoluminal comprehensive treatment for elderly patients with Cockett syndrome complicated by deep venous thrombosis of the left lower extremity in ethnic minority areas

目的探讨腔内综合治疗少数民族地区老龄Cockett综合征伴左下肢深静脉血栓形成(DVT)患者的效果。方法回顾性分析2019年1月至2021年12月在我院诊治符合Cockett综合征伴左下肢DVT入选标准的少数民族地区老龄患者148例的临床资料,所有患者均采用腔内(行下肢深静脉穿刺置管溶栓、髂静脉狭窄球囊扩张支架植入)综合治疗及术后抗凝等治疗。术后随访至少12个月,观察患者的近期疗效、肢体周径差值、下肢深静脉通畅率、血栓复发率及血栓后综合征(PTS)发生情况。结果所有患者行腔内综合治疗均有效,治疗后1周及6、12个月时,大腿周径和小腿周径差值均小于治疗前,差异均有统计学意义(均P<0.001)。影像学检查显示,治疗后6、12个月时的下肢深静脉通畅率分别为91.22%、85.81%,术后血栓复发22例(14.86%),发生PTS 8例(5.41%)。结论腔内综合治疗少数民族地区老龄Cockett综合征伴左下肢DVT的近期效果较好,能改善静脉管腔狭窄,快速清除血栓,远期静脉通畅率高,术后PTS发生率低,能有效提升患者的生活质量。

Objective To explore the application effect of endoluminal comprehensive treatment in elderly patients with Cockett syndrome complicated by deep venous thrombosis(DVT)of the left lower extremity in ethnic minority areas.Methods A retrospective analysis was conducted on 148 elderly patients from ethnic minority areas who met the inclusion criteria for Cockett syndrome complicated by left lower extremity DVT and were treated at Baise People's Hospital from January 2019 to December 2021.All patients underwent endoluminal treatment(including thrombolysis via deep venous puncture and catheterization of the lower extremities,balloon angioplasty,and stent implantation for iliac vein stenosis)combined with anticoagulation therapy.Patients were followed up for at least 12 months to observe early therapeutic effects,limb circumference differences,patency rates of stents and deep veins of the lower extremities,thrombus clearance rates,thrombus recurrence rates,and the occurrence of post-thrombotic syndrome(PTS).Results All patients achieved effective outcomes with endoluminal comprehensive treatment,and clinical success was achieved in thrombus clearance(Grade II or above).One week,6 months,and 12 months after treatment,the differences in thigh and calf circumferences were reduced compared to pre-treatment(all P<0.001).Imaging examinations revealed that the patency rates of stents and vessels were 91.22%at 6 months and 85.81%at 12 months.Postoperative PTS occurred in 8 cases(5.41%),and thrombus recurrence occurred in 22 cases(14.86%).Conclusion Endoluminal comprehensive treatment for elderly patients with Cockett syndrome complicated by left lower extremity DVT in ethnic minority areas achieves good short-term effects,effectively relieves venous stenosis,rapidly eliminates thrombi,maintains a high long-term venous patency rate,and has a low incidence of postoperative PTS,significantly improving patients'quality of life.