[1]郑世宾,郭衍,孙成宏,等.支架成形术治疗以静脉性溃疡为主要表现的非血栓性髂静脉病变效果[J].介入放射学杂志,2020,29(01):25-29.
 ZHENG Shibing,GUO Heng,SUN Chenghong,et al.The curative effect of stent angioplasty for the treatment of non-thrombotic iliac vein lesions characterized mainly by venous ulcers[J].journal interventional radiology,2020,29(01):25-29.
点击复制

支架成形术治疗以静脉性溃疡为主要表现的非血栓性髂静脉病变效果()

PDF下载中关闭

分享到:

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

卷:
29
期数:
2020年01
页码:
25-29
栏目:
血管介入
出版日期:
2020-02-10

文章信息/Info

Title:
The curative effect of stent angioplasty for the treatment of non-thrombotic iliac vein lesions characterized mainly by venous ulcers
作者:
郑世宾郭衍孙成宏张宏中叶开创陆信武
Author(s):
ZHENG Shibing GUO Heng SUN Chenghong ZHANG Hongzhong YE Kaichuang LU Xinwu.
Department of Vascular Surgery, Junan County People’s Hospital, Junan County, Shandong Province 276600, China
关键词:
【关键词】 非血栓性髂静脉病变支架成形术静脉曲张静脉腔内激光治疗静脉性溃疡
文献标志码:
A
摘要:
【摘要】 目的?评价支架成形术治疗非血栓性髂静脉病变(NIVL)对静脉性溃疡愈合的临床意义。 方法?回顾性分析2014年1月至2017年12月收治的下肢静脉性溃疡并经影像学检查确诊为NIVL患者临床资料。根据治疗下肢静脉曲张的同时是否应用支架成形术处理髂静脉病变,将患者分为两组,A组(治疗组)接受大隐静脉高位结扎、静脉腔内激光治疗(EVLT),同期支架成形术处理NIVL;B组(对照组)接受单纯大隐静脉高位结扎、EVLT治疗,未处理髂静脉病变。根据随访结果比较两组患者临床效果。主要研究终点为溃疡愈合率,次要研究终点包括静脉曲张复发率、静脉疾病临床严重度评分(VCSS)。 结果?根据纳入和排除标准共纳入217例患者,A组114例,B组103例。两组患者术前一般资料差异无统计学意义。术后随访1~48个月,平均26个月。A组患者髂静脉支架通畅率为100%。A组、B组患者溃疡愈合率分别为91.2% (104/114)、79.6% (82/103),A组显著高于B组(P=0.02);A组患者平均VCSS评分(4.8)显著低于B组(7.5)(P=0.004);A组静脉曲张复发率(7.0%)显著低于B组(17.5%)(P=0.02)。 结论?支架成形术治疗以静脉性溃疡为主要表现的NIVL安全、有效,可显著促进溃疡愈合、缓解临床症状,降低静脉曲张复发率。

参考文献/References:

1 Lal BK. Venous ulcers of the lower extremity: definition, epidemiology, and economic and social burdensJ. Semin Vasc Surg, 2015, 28: 3-5.
2 Melikian R, Odonnell TF Jr, Suarez L, et al. Risk factors associated with the venous leg ulcer that fails to heal after 1 year of treatmentJ.J Vasc Surg Venous Lymphat Disord, 2019, 7: 98-105.
3 Dzieciuchowicz L, Krzyzanski R, Kruszyna L, et al. Prevalence of non-thrombotic iliac vein lesions in patients with unilateral primary varicose veinsJ. Eur J Vasc Endovasc Surg, 2016, 51: 429-433.
4 叶开创,陆信武,李维敏,等.顺行静脉造影在非血栓性髂静脉受压综合征中的诊断价值J.上海交通大学学报?医学版, 2009,29:1098-1103.
5 Ye K, Lu X, Li W, et al. Long-term outcomes of stent placement for symptomatic nonthrombotic iliac vein compression lesions in chronic venous diseaseJ. J Vasc Interv Radiol, 2012, 23: 497-502.
6 Lu X, Ye K, Li W, et al. Endovenous ablation with laser for great saphenous vein insufficiency and tributary varices: a retrospective evaluationJ. J Vasc Surg, 2008, 48: 675-679.
7 Raffetto JD. Pathophysiology of chronic venous disease and venous ulcersJ. Surg Clin North Am, 2018, 98: 337-347.
8 吴 霜,顾建平,楼文胜.髂静脉受压综合征病因及诊疗研究进展J.介入放射学杂志, 2015, 24:733-737.
9 Wittens C, Davies AH, Bækgaard N, et al. Editors choice - management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS)J. Eur J Vasc Endovasc Surg, 2015, 49:678-737.
10 Mousa AY, Broce M, Yacoub M, et al. Validation of venous duplex ultrasound imaging in determining iliac vein stenosis after standard treatment of active chronic venous ulcersJ. J Vasc Surg Venous Lymphat Disord, 2016, 4: 307-312.
11 Mousa AY, Broce M, Yacoub M, et al. Iliac vein interrogation augments venous ulcer healing in patients who have failed standard compression therapy along with pathological venous closureJ. Ann Vasc Surg, 2016, 34: 144-151.
12 Garg N, Gloviczki P, Karimi KM, et al. Factors affecting outcome of open and hybrid reconstructions for nonmalignant obstruction of iliofemoral veins and inferior vena cavaJ. J Vasc Surg, 2011, 53: 383-393.
13 Alhalbouni S, Hingorani A, Shiferson A, et al. Iliac-femoral venous stenting for lower extremity venous stasis symptomsJ. Ann Vasc Surg, 2012, 26: 185-189.
14 Rizvi SA, Ascher E, Hingorani A, et al. Stent patency in patients with advanced chronic venous disease and nonthrombotic iliac vein lesionsJ. J Vasc Surg Venous Lymphat Disord, 2018, 6: 457-463.
15 George R, Verma H, Ram B, et al. The effect of deep venous stenting on healing of lower limb venous ulcersJ. Eur J Vasc Endovasc Surg, 2014, 48: 330-336.
16 Vemulapalli S, Parikh K, Coeytaux R, et al. Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veinsJ. Am Heart J, 2018, 196: 131-143.
17 Kong J, Liu P, Li JY, et al. Surgical treatment of recurrent varicose veins in the lower limbs associated with endovascular treatment of iliac vein stenosisJ. Int J Surg, 2018, 50: 110-113.
18 Yang L, Liu J, Cai H, et al. The clinical outcome of a one-stop procedure for patients with iliac vein compression combined with varicose veinsJ. J Vasc Surg Venous Lymphat Disord, 2018, 6: 696-701.
19 Lurie F, Bittar S, Kasper G. Optimal compression therapy and wound care for venous ulcersJ. Surg Clin North Am, 2018, 98: 349-360.
(收稿日期:2019-02-11)
(本文编辑:边佶)

相似文献/References:

[1]陆南,黄清海,张永巍,等.症状性颅内动脉狭窄支架成形术后早期新发缺血性脑损害的临床研究[J].介入放射学杂志,2009,(11):803.
 LU Nan,HUANG Qinghai,ZHANG Yongwei,et al.Early cerebral ischemic lesions ly after stenting for symptomatic intracranial artery stenosisa clinical study[J].journal interventional radiology,2009,(01):803.

备注/Memo

备注/Memo:
(收稿日期:2019-02-11)
(本文编辑:边佶)
更新日期/Last Update: 2020-02-08