不同类型支架治疗狭窄、闭塞性髂静脉疾病中期随访分析
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(赤峰市医院血管外科,内蒙古 赤峰 024099)

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R543.6

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2020-2021赤峰市自然科学科研课题(SZR183)


Efficacy of different types of stents for stenosis and occlusive iliac vein disease:a mid-term follow-up analysis
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(Department of Vascular Surgery, Chifeng Hospital, Chifeng 024099, Inner Mongolia Autonomous Region, China)

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    摘要:

    目的 通过随访评价支架置入治疗髂静脉狭窄、闭塞性疾病的中期疗效,比较不同类型支架的疗效及并发症发生情况。方法 回顾性分析2018年6月至2020年6月赤峰市医院血管外科收治的83例单侧髂静脉狭窄、闭塞接受支架置入患者的临床资料,并对患者进行中期(3~12个月)随访。比较编织型支架(编织支架组,34例)与激光雕刻支架(激光支架组,49例)患者的疗效及并发症发生情况,并从消肿率、靶血管一期通畅率、静脉临床严重程度评分(VCSS)变化及并发症发生率等方面评价中期效果。采用SPSS 13.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ2检验进行组间比较。结果 随访时2组患者患/健侧的大、小腿周径差均较治疗前降低,差异有统计学意义(P<0.05);VCSS评分均较治疗前降低,差异均有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);患肢消肿率、一期通畅率比较,差异无统计学意义(P>0.05)。编织支架组对侧髂静脉血栓、支架位移、支架内血栓形成等并发症总发生率高于激光雕刻支架组[20.59%(7/34)和4.08%(2/49)],差异有统计学意义(P<0.05)。结论 支架置入治疗髂静脉狭窄、闭塞性病变安全有效,编织型支架与激光雕刻支架治疗效果接近,但激光雕刻支架定位更加准确,且引起的相关并发症更少。

    Abstract:

    Objective To compare the efficacy and complications of different types of stents in the treatment of iliac vein stenosis and occluded diseases by observing the mid-term outcomes after stent implantation. Methods The clinical data of 83 patients with unilateral iliac vein stenosis or occlusion treated with stenting in our department from June 2018 to June 2020 were collected and analyzed retrospectively. All of the patients were followed up for 3-12 months (mid-term). The efficacy and incidence of complications were compared between the patients undergoing woven stent (woven stent group, n=34) and laser engraving stent (laser stent group, n=49). The clinical outcomes were evaluated for the mid-term clinical efficacy in terms of swelling rate, primary patency rate of the target vessel, venous clinical severity score (VCSS) and complication rate. The obtained data were analyzed by SPSS statistics 13.0, and the intergroup comparison was conducted with student′s t test or Chi-square test based on different data types. Results The circumferences of the thigh and the calf of the affected side were obviously decreased at follow-up than those before treatment in both groups (P<0.05). So was the VCSS score before and after treatment (P<0.05), but there was no statistical difference in the score between the two groups (P>0.05). No differences were seen in the swelling rate and primary patency rate of the target vessel between the two groups (P>0.05). The incidence of contralateral iliac vein thrombosis, stent displacement and stent thrombosis were higher in the woven stent group than the laser engraving stent group [20.59% (7/34) vs 4.08% (2/49)], the difference was statistically significant (P<0.05). Conclusion Stent implantation is safe and effective in the treatment of iliac vein stenosis and occlusion. Woven stents show similar efficacy as laser engraving stents and obtain more accurate positioning and lower complication incidences.

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姜学超,党永康,杨柳,郭建全,鲍永涛,仝向阳,彭战利,乌兰.不同类型支架治疗狭窄、闭塞性髂静脉疾病中期随访分析[J].中华老年多器官疾病杂志,2022,21(3):189~193

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  • 收稿日期:2021-05-25
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  • 在线发布日期: 2022-03-28
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