[1]厉祥涛,单 硕,张 欢,等.盆腔静脉疾病合并盆腔外静脉曲张“自上而下”治疗——单中心经验[J].介入放射学杂志,2026,(09):985-991.[doi:10.3969/j.issn.1008-794X.2026.09.004]
　LI Xiangtao,SHAN Shuo,ZHANG Huan,et al.The “from top to bottom” treatment mode for pelvic venous disorders associated with extra-pelvic varicose veins:a single-center experience[J].J Intervent Med,2026,(09):985-991.[doi:10.3969/j.issn.1008-794X.2026.09.004]
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盆腔静脉疾病合并盆腔外静脉曲张“自上而下”治疗——单中心经验()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年09
页码:
985-991
栏目:
血管介入
出版日期:
2026-09-10

文章信息/Info

Title:
The “from top to bottom” treatment mode for pelvic venous disorders associated with extra-pelvic varicose veins:a single-center experience
文章编号:
1008-794X(2026)-009-0985-07
作者:
厉祥涛;  单 硕;  张 欢;  牛鹿原;  张福先;  胡 路;  罗小云
100038 北京 首都医科大学附属北京世纪坛医院血管外科
Author(s):
LI Xiangtao; SHAN Shuo; ZHANG Huan; NIU Luyuan; ZHANG Fuxian; HU Lu; LUO Xiaoyun.
Department of Vascular Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China
关键词:
盆腔静脉疾病;  盆腔外静脉曲张;  卵巢静脉栓塞;  泡沫硬化剂;  盆腔逃逸点
分类号:
R543.6
DOI:
10.3969/j.issn.1008-794X.2026.09.004
文献标志码:
A
摘要:
目的 回顾单中心在前期简化卵巢静脉栓塞策略基础上,联合选择性盆腔外逃逸点及曲张静脉局部处理的“自上而下”策略治疗盆腔静脉疾病(pelvic venous disorders,PeVD)合并盆腔外静脉曲张的临床经验,评估治疗安全性和近期效果。方法 回顾性分析北京世纪坛医院2020年1月至2025年5月收治的32例女性PeVD合并盆腔外静脉曲张并接受盆腔静脉栓塞治疗患者。所有患者均经超声、CT静脉造影及导管静脉造影确诊。治疗策略为简化卵巢静脉弹簧圈栓塞联合泡沫硬化剂注射。根据病变范围、症状持续时间及患者意愿,对盆腔外逃逸点及残余曲张静脉选择同期或分期行泡沫硬化剂注射或点状剥脱术。记录术前临床资料、影像学特征、手术细节、并发症及术后1、3、6、12个月随访结果。结果 32例患者平均年龄(40.7±8.8)岁,中位病程3.2年,中位随访19个月。24例为美国静脉与淋巴学会(AVLS)症状-曲张静脉-病理生理(SVP)分型S3ab型(外阴静脉曲张合并下肢非典型静脉曲张),8例为S3a型(单纯外阴静脉曲张)。逃逸点分型为阴部型18例、腹股沟型12例、闭孔型2例。所有患者均存在左卵巢静脉反流[直径(8.9±1.1)mm],左、右宫旁静脉直径分别为(7.4±0.9)mm、(6.1±0.7)mm。所有患者均完成左卵巢静脉弹簧圈栓塞(平均2.6枚可控弹簧圈)联合泡沫硬化剂治疗,1例同期植入髂静脉支架,10例同期行局部泡沫硬化或点状剥脱治疗。技术成功率为100%。并发症发生率为12.5%,均为轻度一过性疼痛。术后3个月,视觉模拟量表(VAS)评分由(7.2±1.3)分降至(1.8±1.4)分(P<0.001),左、右宫旁静脉直径分别降至(3.2±0.6)mm、(2.9±0.5)mm(均P<0.001); 24例S3ab型患者静脉疾病临床严重度评分(VCSS)由(4.5±1.1)分降至(0.4±0.5)分(P<0.001)。术后12个月随访,未见临床复发。结论 “自上而下”盆腔静脉栓塞联合局部处理曲张静脉是治疗PeVD合并盆腔外静脉曲张安全有效的策略,可显著缓解盆腔症状、改善体表曲张,值得临床推广。其远期疗效尚需多中心前瞻性研究进一步验证。

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(收稿日期:2026-03-02)
(本文编辑:谷 珂)

备注/Memo

备注/Memo:
基金项目: 国家铁路集团课题重点项目(N2024Z006JB)
通信作者: 罗小云 E-mail:xiaoyunluo@ccmu.edu.cn
更新日期/Last Update: 2026-09-25