摘要
髂静脉受压综合征(IVCS)是由外在压迫引起的静脉流出道部分或全部受阻,继而引起阻塞,导致同侧肢体广泛深静脉血栓(DVT)。若治疗不及时,远期发展成血栓后综合征(PTS)的可能性较大,进而导致下肢静脉高压,出现下肢静脉性溃疡和皮肤色素沉着等并发症。对于合并IVCS的DVT,除了快速清除并减少血栓负荷,同时需要及时解除髂静脉梗阻,提高DVT治疗的远期有效率和通畅率,但处理髂静脉狭窄的时机目前尚未统一,基于其临床表现的治疗方案包括抗凝治疗、分阶段溶栓治疗(有/无预防性下腔静脉滤器置入)、导管直接溶栓(CDT)、机械性血栓清除术、血管腔内成形术等。目前,髂静脉支架植入已显示出良好的长期通畅率和临床结果,成为临床研究的热点,本文对IVCS合并DVT的临床诊疗情况做一综述。
Iliac vein compression syndrome(IVCS)is an obstruction of the venous outflow tract caused by external compression.Part or all of the venous outflow tract is blocked,which then causes obstruction,leading to extensive deep vein thrombosis(DVT)in the ipsilateral extremity.If not treated promptly,there is a high possibility of developing into post thrombotic syndrome(PTS)in the long term,leading to lower extremity venous hypertension,lower extremity venous ulcers,and skin pigmentation and other complications.For DVT with IVCS,in addition to quickly clearing and reducing thrombus burden,timely relief of iliac vein obstruction is necessary to improve the long-term effectiveness and patency rate of DVT treatment.However,there is no unified conclusion on the timing of iliac vein stenosis treatment at present.The treatment scheme is based on its clinical manifestations,including anticoagulation,staged thrombolysis(with or without the placement of preventive inferior vena cava filters),direct catheter thrombolysis(CDT),mechanical thrombus clearance,and endovascular angioplasty.At present,iliac vein stent implantation has shown good long-term patency rate and clinical results,becoming a hot topic in clinical research.This article will provide a review of the clinical diagnosis and treatment of IVCS combined with DVT.
作者
马青
刘宗芬
孙波
张纪存
裴长安
胡潍青
Ma Qing;Liu Zongfen;Sun Bo;Zhang Jicun;Pei Chang'an;Hu Weiqing(Department of Pharmacy,Weifang People's Hospital,Weifang 261041,Shandong,China;School of Clinical Medicine,Weifang Medical University,Weifang 261000,Shandong,China;Department of Vascular Surgery,Weifang People's Hospital,Weifang 261041,Shandong,China)
出处
《血管与腔内血管外科杂志》
2023年第6期701-704,709,共5页
Journal of Vascular and Endovascular Surgery
基金
山东省潍坊市卫生健康委员会科研项目(wfwsjk_2019_005)。
关键词
髂静脉受压综合征
下肢深静脉血栓形成
髂静脉支架
血栓切除术
抗凝治疗
iliac vein compression syndrome
lower extremity deep vein thrombosis
iliac vein stent
thrombectomy
anticoagulant therapy
