老年患者左髂静脉受压综合征的腔内治疗
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Interventional therapy for 1eft iliac vein compressed syndrome inelderly patients
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    摘要:

    目的 探讨老年患者左髂静脉受压综合征的腔内治疗效果。方法 50例左髂静脉受压综合征患者均采用腔内治疗, 经股静脉入路行左髂静脉病变段球囊扩张加支架植入术。合并血栓形成者, 先行下腔静脉滤器植入和左下肢深静脉插管溶栓术, 二期处理左髂静脉病变; 合并静脉曲张者, 二期手术治疗。结果 球囊扩张成功39例, 支架置入30例, 本组无死亡和肺栓塞发生。出院时肢体肿胀明显减轻; 血栓完全溶解15例, 部分溶解2例, 血栓后遗症表现4例; 静脉曲张者曲张静脉症状减轻; 7例溃疡愈合。41例随访患者中, 2例支架内血栓形成, 1例支架狭窄移位。结论 血管腔内治疗左髂静脉受压综合征对老年患者创伤小, 恢复快, 并发症少, 近期效果良好, 远期疗效尚需进一步观察。

    Abstract:

    Objective To evaluate the effects of interventional therapy for 1eft iliac vein compressed syndrome in elderly patients. Methods Fifty cases of 1eft iliac vein compressed syndrome underwent stent placement and balloon angioplasty through the femoral vein. For patients who had thrombosis, an inferior vena cava (IVC) filter device was placed firstly and transcatheter thrombolysis via the popliteal vein was performed, then 1eft iliac vein compressed syndrome was treated sequentially. For patients with varices, staged saphenous vein high ligation and stripping was carried out. Results The stenosis or occlusive segments of left iliac vein were suc-cessfully dilated in 39 cases, of which 30 cases received stent implantation, and no in-hospital death or pulmonary embolism was reported. The leg swelling was greatly relieved at discharge. Thrombus disappeared completely in 15 cases and partly in 2 cases. Post-thrombosis syndrome was reported in 4 cases. The symptoms of varicose vein were dramatically lessened. Leg ulcers healed completely in 7 cases. Among 41 cases who had follow-up results, in-stent thrombus formation was observed in 2 case, and in-stent restenosis and stent displacement in 1 case. Conclusion Interventional therapy for 1eft iliac vein compressed syndrome in elderly patients has the advantages of less trauma, quick recovery, and less complications. The short-term efficacy is satisfactory, and long-term efficacy still needs further study.

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李传勇, 沈超, 孙蓬.老年患者左髂静脉受压综合征的腔内治疗[J].中华老年多器官疾病杂志,2011,10(4):326~328

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