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  • 范伟健,胡楠,程杰,等.腔内同期及分期手术方案对髂静脉压迫综合征合并静脉曲张的疗效比较[J].同济大学学报(医学版),2021,42(2):226-231.    [点击复制]
  • FAN Wei-jian,HU Nan,CHENG Jie,et al.Comparison of simultaneous and staging intracavitary procedures for left iliac vein compression syndrome with varicose great saphenous vein[J].同济大学学报(医学版),2021,42(2):226-231.   [点击复制]
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腔内同期及分期手术方案对髂静脉压迫综合征合并静脉曲张的疗效比较
范伟健,胡楠,程杰,刘杰,金逸,李茂全,左克强
0
(安徽理工大学医学院,安徽 淮南232001;同济大学附属第十人民医院介入血管外科,上海200072)
摘要:
目的评估腔内同期及分期治疗髂静脉压迫综合征合并下肢静脉曲张临床疗效及费用比较。方法回顾性分析腔内同期及分期治疗髂静脉压迫综合征合并下肢静脉曲张同期治疗患者50例(A组)、分期治疗46例患者(B组)的临床资料及随访结果。采用下肢深静脉造影或血管彩超评估髂静脉狭窄治疗结果;采用静脉疾病严重程度评分评估静脉曲张治疗结果。结果同期及分期两组均行髂静脉支架置入术+大隐静脉高位结扎、激光闭合、点式剥脱术,技术成功率100%;无1例患者出现DVT、PE、过敏性休克、脑卒中及死亡等严重疾病发生。两组间技术成功和并发症差异均无统计学意义(P>0.05)。两组患者术后6个月行下肢深静脉造影提示左髂静脉均通畅,无下肢深静脉血栓形成等并发症。两组患者下肢静脉曲张均无复发(P>0.05)。A组患者的平均住院费用及平均住院天数显著低于B组(P<0.05)。结论腔内同期或分期对髂静脉压迫综合征合并下肢静脉曲张微创治疗都有良好的近期临床效果,但同期治疗可缩短患者住院时间,降低患者住院费用,更具有一定的推广价值。
关键词:  髂静脉压迫综合征  下肢静脉曲张  激光闭合术  支架置入术
DOI:10.12289/j.issn.1008-0392.20227
投稿时间:2020-05-18
基金项目:同济大学国自然培育计划(SYGZRPY2017060)
Comparison of simultaneous and staging intracavitary procedures for left iliac vein compression syndrome with varicose great saphenous vein
FAN Wei-jian,HU Nan,CHENG Jie,LIU Jie,JIN Yi,LI Mao-quan,ZUO Ke-qiang
(Medical College, Anhui University of Science and Technology, Huainan 232001, Anhui Province, China;Dept. of Interventional & Vascular Surgery, Shanghai Tenth Peoples Hospital, School of Medicine, Tongiji University, Shanghai 200072, China)
Abstract:
ObjectiveTo compare the efficacy and cost of simultaneous and staging treatment for left iliac vein compression syndrome with varicose great saphenous vein. MethodsThe clinical data and follow-up results of 96 patients with left iliac vein stenosis and great saphenous vein varicose treated in Shanghai Tenth Peoples Hospital from April 2011 to September 2018 were retrospectively analyzed, among whom 50 cases received simultaneous procedures(group A) and 46 cases received staging procedures(group B). The iliac vein stenosis were evaluated by deep venography or color doppler ultrasound. Venous disease severity score(VCSS) was used to evaluate the outcome of treatment for varicose veins. ResultsBoth groups were treated with iliac vein stent implantation, high ligation of great saphenous vein, laser closure and point stripping. The technical success rate of 100%; and there were no deep vein thrombosis(DVT), pulmonary embolism(PE), anaphylactic shock, stroke and other serious complications in two groups. Six months after operation, the left iliac vein was unobstructed and no complications occurred, and there was no recurrence in both groups. The average hospitalization cost and average hospitalization days in group A were significantly lower than that of group B(P<0.05). ConclusionBoth simultaneous or staging procedures for treatment of left iliac vein stenosis with varicose great saphenous vein have good short-term clinical efficacy, but simultaneous treatment can shorten the length of hospital stay and reduce the hospitalization cost, which has a certain promotion value.
Key words:  iliac vein compression syndrome  varicose venous in lower extremity  endovenous laser treatment  stent implantation

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