下肢静脉曲张及髂静脉压迫综合征的步进DSA技术诊断与治疗

Diagnosis and Treatment of Lower Extremity Varicose Veins and Iliac Vein Vompression Syndrome by Step-by-Step DSA Technique

目的本研究旨在探讨步进数字减影血管造影技术(DSA)在下肢静脉曲张及髂静脉压迫综合征诊断中的应用价值,并比较改良式激光腔内闭合术与传统大隐静脉高扎剥脱术的治疗效果。方法选取2018年1月至2023年12月在我院接受治疗的100例下肢静脉曲张患者作为研究对象。所有患者均接受下肢静脉彩超和步进DSA检查,观察髂静脉压迫情况,并根据检查结果分为两组:观察组(改良式激光腔内闭合术)和对照组(传统大隐静脉高扎剥脱术),每组各50例。记录并分析两组患者的静脉曲张消失、水肿消退、静息痛缓解、皮肤色素沉着改善、手术时间、住院时间、疼痛评分、瘀斑血肿等并发症情况。结果100例患者通过彩超发现髂静脉压迫患者占10%(10例),步进DSA技术发现髂静脉压迫占20%(20例),其中重度压迫者5例,观察组在静脉曲张消失率、水肿消退时间、静息痛缓解率、皮肤色素沉着改善率方面均高于对照组(均P<0.05)。观察组的手术时间、住院时间及水肿消退时间均短于对照组,疼痛评分及并发症总发生率均低于对照组(均P<0.05)。结论步进DSA技术为下肢静脉曲张及髂静脉压迫综合征的诊断提供了准确可靠的方法。改良式激光腔内闭合术相较于传统大隐静脉高扎剥脱术,具有更好的治疗效果和较低的并发症发生率。

Objective The purpose of this study was to investigate the application value of stepped digital subtraction angiography(DSA)technique in the diagnosis of lower limb varicose veins and iliac vein compression syndrome,and to compare the therapeutic effect of improved laser intracavitary closure and traditional saphenous vein high ligature dissection.Methods A total of 100 patients with lower extremity varicose veins treated in our hospital from January 2018 to December 2023 were selected as the study objects.All patients underwent lower extremity venous color ultrasound and step-by-step DSA examination to observe iliac vein compression,and according to the results of the examination were divided into two groups:observation group(modified laser endovascular closure)and control group(traditional saphenous vein high ligature exfoliation),with 50 cases in each group.Complications such as the disappearance of varicose veins,the regression of edema,the relief of resting pain,the improvement of skin pigmentation,the duration of operation,the length of hospital stay,the pain score and the hematoma of ecchymosis were recorded and analyzed in the two groups.Results Iliac vein compression was found in 10%(10 cases)of 100 patients by color ultrasound,and 20%(20 cases)by step DSA technique,including 5 cases of severe oppressors.The rate of varicose disappearance,time of edema resolution,resting pain relief rate and skin pigmentation improvement rate in the iliac vein observation group were significantly higher than those in the control group(all P<0.05).The operation time,hospital stay and oedema subsidence time of the observation group were shorter than those of the control group,and the pain score and total complication rate were lower than those of the control group(all P<0.05).Conclusions Stepwise DSA technique provides an accurate and reliable method for the diagnosis of lower limb varicose veins and iliac vein compression syndrome.Compared with traditional saphenous vein exfoliation,improved laser endovascular closure has better therapeutic effect and lower complication rate.