髂静脉支架植入术后对侧髂静脉血栓形成情况分析

Analysis of contralateral iliac vein thrombosis after iliac vein stent implantation surgery

目的探讨髂静脉支架植入术后对侧髂静脉血栓形成情况。方法收集2018年6月至2021年6月于湖北省中医院(湖北省中医药研究院/湖北省中医药大学附属医院)行单侧髂静脉支架植入术的152例患者的临床资料,根据髂静脉支架植入术后对侧髂静脉是否形成血栓将患者分为观察组(n=7,髂静脉支架植入术后对侧髂静脉血栓形成)和对照组(n=145,髂静脉支架植入术后对侧髂静脉血栓未形成)。比较两组患者的临床特征、永久型腔静脉滤器植入情况、髂静脉支架覆盖对侧髂静脉开口范围及术后规律服用抗凝药物情况。结果两组患者的年龄、性别、高血压史、糖尿病史、冠心病史、恶性肿瘤病史、易栓症发生情况及肾病综合征发生情况比较,差异均无统计学意义(P﹥0.05)。两组患者的永久型腔静脉滤器植入率、髂静脉支架覆盖对侧髂静脉开口范围为Ⅰ级和Ⅲ级的比例、术后规律服用抗凝药物情况比较,差异均有统计学意义(P﹤0.05)。两组患者髂静脉支架覆盖对侧开口范围为Ⅱ级的比例比较,差异无统计学意义(P﹥0.05)。结论髂静脉支架植入术后对侧髂静脉血栓形成的发生率低。引起对侧髂静脉血栓形成的影响因素主要是永久型腔静脉滤器植入情况、髂静脉支架覆盖对侧髂静脉开口范围和术后是否规律抗凝治疗。

Objective To investigate the formation of contralateral iliac vein thrombosis after iliac vein stent implantation surgery.Method The clinical data of 152 patients who underwent unilateral iliac vein stent implantation surgery at Hubei Provincial Hospital of Traditional Chinese Medicine(Hubei Provincial Academy of Traditional Chinese Medicine/Affiliated Hospital of Hubei University of Traditional Chinese Medicine)from June 2018 to June 2021 were collected.The patients were divided into observation group(n=7,contralateral iliac vein thrombosis after iliac vein stent implantation)and control group(n=145,contralateral iliac vein thrombosis did not form after iliac vein stent implantation)based on the occurrence of contralateral iliac vein thrombosis after iliac vein stent implantation surgery.The clinical characteristics,the implantation of permanent vena cava filters,iliac vein stents covering the contralateral iliac vein opening,and regular use of anticoagulant drugs after surgery of two groups of patients were compared.Result There were no significant differences between the two groups in age,gender,hypertension history,diabetes history,coronary heart disease history,malignant tumor history,thrombophilia and nephrotic syndrome(P>0.05).There were statistically significant differences in the implantation rate of permanent vena cava filters,the proportion of iliac vein stents covering the contralateral iliac vein opening of grade I and III,and the regular use of anticoagulant drugs after surgery between the two groups of patients(P<0.05).There was no statistically significant difference in the proportion of iliac vein stents covering the contralateral opening range of grade II on the contralateral opening between the two groups(P>0.05).Conclusion The incidence of contralateral iliac vein thrombosis after iliac vein stent implantation is low.The main influence factors of contralateral iliac vein thrombosis are permanent vena cava filter implantation,iliac vein stent covering the contralateral iliac vein opening and whether anticoagulation is regular after surgery.