右髂静脉受压综合征的病因分析及介入治疗
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摘要
目的:探讨右髂静脉受压综合征的病因及介入治疗的临床疗效。方法:回顾性分析2012年8月至2017年12月右髂静脉压迫综合征患者的临床资料,并分析其原因,临床症状,体征,诊断,治疗方案和疗效。结果:共22患者纳入分析,病因为动脉压迫的患者18例,非髂动脉压迫4例(子宫增大压迫1例,髂血管旁囊肿压迫1例,术后盆腔黏连带压迫1例,盆腔骨折致组织水肿压迫1例),行保守治疗9例,病变段球囊扩张7例,病变段球囊扩张加支架植入6例。随访3-22个月,患者的临床症状和体征均得到了不同程度的缓解。结论:右髂静脉受压综合征的病因包括右髂动脉、盆腔占位性病变以及盆腔术后黏连等因素压迫右侧髂静脉,因动脉压迫导致的右髂静脉受压综合征行血管内介入治疗具有良好的近中期效果。
Objective:To investigate the clinical therapeutic effects of right iliac vein compression syndrome and interventional treatment.Methods:The clinical data of patients with right iliac vein compression syndrome in the First Affiliated Hospital of Bengbu Medical College from August 2012 to December 2017 were retrospectively analyzed and the causes, clinical symptoms, signs, treatment options and efficacy were analyzed. Results:A total of 22 patients were included in the analysis, which was caused by 18 cases of radial artery compression and 4 cases of non-iliac artery compression(1 case of uterus enlargement and compression, 1 case of cystic paratubular cyst compression, 1 case of postoperative pelvic adhesions compression, and pelvic fracture. 1 case of tissue edema compression), conservative treatment in 9 cases, balloon dilatation in 7 cases, balloon dilatation and stent angioplasty in 6 cases. Follow-up 3 to 22 months, the patient's clinical symptoms and signs were all relieved to varying degrees. Conclusion:The causes of right iliac vein compression syndrome include right iliac artery, pelvic space-occupying lesions, pelvic adhesions and other factors that cause compression of the right axillary vein.Intravascular interventional therapy for right iliac vein compression syndrome due to arterial compression has a good near-midterm effect.
Objective:To investigate the clinical therapeutic effects of right iliac vein compression syndrome and interventional treatment.Methods:The clinical data of patients with right iliac vein compression syndrome in the First Affiliated Hospital of Bengbu Medical College from August 2012 to December 2017 were retrospectively analyzed and the causes, clinical symptoms, signs, treatment options and efficacy were analyzed. Results:A total of 22 patients were included in the analysis, which was caused by 18 cases of radial artery compression and 4 cases of non-iliac artery compression(1 case of uterus enlargement and compression, 1 case of cystic paratubular cyst compression, 1 case of postoperative pelvic adhesions compression, and pelvic fracture. 1 case of tissue edema compression), conservative treatment in 9 cases, balloon dilatation in 7 cases, balloon dilatation and stent angioplasty in 6 cases. Follow-up 3 to 22 months, the patient's clinical symptoms and signs were all relieved to varying degrees. Conclusion:The causes of right iliac vein compression syndrome include right iliac artery, pelvic space-occupying lesions, pelvic adhesions and other factors that cause compression of the right axillary vein.Intravascular interventional therapy for right iliac vein compression syndrome due to arterial compression has a good near-midterm effect.
引文
[1] Knuttinen MG,Naidu S,Oklu R,et al.May-Thurner:diagnosis and endovascular management[J].Cardiovascular diagnosis and therapy,2017,7(Suppl 3):S159-S164.
[2] 陈兆雷,张喜成,孙元,等.右髂静脉受压综合征的临床特征及腔内治疗[J].中华普通外科杂志,2016,(4):344-345.
[3] 杨明烽,周忠良,马旭,等.右侧髂静脉受压综合征一例[J].中国血管外科杂志(电子版),2014,(2):116-117.
[4] Du Pont B,Verbist J,Van den EyndeW.Right-sided Cockett's syndrome[J].Acta chirurgicaBelgica,2016,116(2):114-118.
[5] 罗明华,关怀敏,解金红,等.冠心病药物涂层支架置入后再内皮化研究[J].实用医学杂志,2016,(5):724-727.
[6] 吕续成,沈雳,洪斌,等.生物可吸收支架内血栓的光学相干断层成像发现及原因分析[J].中国介入心脏病学杂志,2017,(10):589-593.
[7] 涂小飞.髂股静脉血栓患者和无症状人群的右髂静脉受压程度研究[D].南昌:南昌大学,2016.
[8] 李开龙,宋兵,王少春.超声对左下肢深静脉血栓合并Cockett综合征的临床诊断价值[J].中华诊断学电子杂志,2017,5(3):183-187.
[9] 桑宏飞,李晓强,姜坤,等.血管腔内超声在髂静脉受压综合征诊治中的应用[J].中华普通外科杂志,2015,(5):407-408.
[10] Lamba R,Tanner DT,Sekhon S,et al.Multidetector CT of Vascular Compression Syndromes in the Abdomen and Pelvis-Erratum[J].Radiographics:a review publication of the Radiological Society of North America, Inc,2015,35(3):973.
[11] 薛海林,王利伟,王绍娟,等.磁共振静脉造影诊断Cockett综合征的价值[J].介入放射学杂志,2017,26(9):783-786.
[12] 胡蓝月,顾建平,王利伟,等.多层螺旋CT与DSA诊断髂静脉受压综合征的比较研究[J].介入放射学杂志,2015,24(4):301-305.
[13] 虞丰,李晓强.髂静脉受压综合征腔内治疗并发症原因分析及防治[J].中国血管外科杂志(电子版),2015,7(4):256-258,283.
[14] Shi WY,Gu JP,Liu CJ,et al.Endovascular treatment for iliac vein compression syndrome with or without lower extremity deep vein thrombosis: A retrospective study on mid-term in-stent patency from a single center[J].European journal of radiology,2016,85(1):7-14.
[15] Dasari M,Avgerinos E,Raju S,et al.Outcomes of iliac vein stents after pregnancy[J].Journal of vascular surgery.Venous and lymphatic disorders,2017,5(3):353-357.
[2] 陈兆雷,张喜成,孙元,等.右髂静脉受压综合征的临床特征及腔内治疗[J].中华普通外科杂志,2016,(4):344-345.
[3] 杨明烽,周忠良,马旭,等.右侧髂静脉受压综合征一例[J].中国血管外科杂志(电子版),2014,(2):116-117.
[4] Du Pont B,Verbist J,Van den EyndeW.Right-sided Cockett's syndrome[J].Acta chirurgicaBelgica,2016,116(2):114-118.
[5] 罗明华,关怀敏,解金红,等.冠心病药物涂层支架置入后再内皮化研究[J].实用医学杂志,2016,(5):724-727.
[6] 吕续成,沈雳,洪斌,等.生物可吸收支架内血栓的光学相干断层成像发现及原因分析[J].中国介入心脏病学杂志,2017,(10):589-593.
[7] 涂小飞.髂股静脉血栓患者和无症状人群的右髂静脉受压程度研究[D].南昌:南昌大学,2016.
[8] 李开龙,宋兵,王少春.超声对左下肢深静脉血栓合并Cockett综合征的临床诊断价值[J].中华诊断学电子杂志,2017,5(3):183-187.
[9] 桑宏飞,李晓强,姜坤,等.血管腔内超声在髂静脉受压综合征诊治中的应用[J].中华普通外科杂志,2015,(5):407-408.
[10] Lamba R,Tanner DT,Sekhon S,et al.Multidetector CT of Vascular Compression Syndromes in the Abdomen and Pelvis-Erratum[J].Radiographics:a review publication of the Radiological Society of North America, Inc,2015,35(3):973.
[11] 薛海林,王利伟,王绍娟,等.磁共振静脉造影诊断Cockett综合征的价值[J].介入放射学杂志,2017,26(9):783-786.
[12] 胡蓝月,顾建平,王利伟,等.多层螺旋CT与DSA诊断髂静脉受压综合征的比较研究[J].介入放射学杂志,2015,24(4):301-305.
[13] 虞丰,李晓强.髂静脉受压综合征腔内治疗并发症原因分析及防治[J].中国血管外科杂志(电子版),2015,7(4):256-258,283.
[14] Shi WY,Gu JP,Liu CJ,et al.Endovascular treatment for iliac vein compression syndrome with or without lower extremity deep vein thrombosis: A retrospective study on mid-term in-stent patency from a single center[J].European journal of radiology,2016,85(1):7-14.
[15] Dasari M,Avgerinos E,Raju S,et al.Outcomes of iliac vein stents after pregnancy[J].Journal of vascular surgery.Venous and lymphatic disorders,2017,5(3):353-357.