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浙江大学学报（医学版）
浙江大学学报（医学版）  2018, Vol. 47 Issue (6): 623-627    DOI: 10.3785/j.issn.1008-9292.2018.12.10
专题报道     
经皮机械血栓清除联合支架植入治疗急性髂股静脉血栓形成患者中远期疗效评估
余钻标(),林作栋,郎德海*()
宁波市第二医院血管外科, 浙江 宁波 315010
Long-term efficacy of percutaneous mechanical thrombectomy combined with stent implantation in treatment of acute iliofemoral venous thrombosis
YU Zuanbiao(),LIN Zuodong,LANG Dehai*()
Department of Vascular Surgery, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang Province, China
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摘要：

目的: 评估经皮机械血栓清除（PMT）联合支架植入治疗急性髂股静脉血栓形成患者的中远期疗效。方法: 收集宁波市第二医院2015年11月至2017年11月因急性髂股静脉血栓形成行PMT联合支架植入70例患者的临床资料，观察支架植入后血流通畅改善情况，术后随访通过Villalta评分量表评估患者血栓后综合征发生情况，并行下肢超声或造影检查评估支架通畅情况。结果: 70例PMT联合髂静脉支架植入患者术后血流均明显改善，血栓Ⅲ级清除62例（88.6%），Ⅱ级清除5例（7.1%），Ⅰ级清除3例（4.3%）。吸栓期间无严重并发症发生。术后平均随访时间为（15.0±2.5）个月，64例（91.4%）患者支架通畅，9例（12.8%）患者出现不同程度的血栓后综合征。结论: PMT联合支架植入治疗急性髂股静脉血栓效果良好，中远期支架通畅率较高。
关键词： 血栓溶解疗法/方法;  髂静脉;  急性病;  静脉血栓形成;  下肢/血液供给;  治疗结果;  支架    
Abstract:

Objective: To evaluate the long-term efficacy of percutaneous mechanical thrombectomy (PMT) combined with stent implantation in treatment of acute iliofemoral vein thrombosis. Methods: Seventy patients with acute iliac vein thrombosis were treated with PMT combined stent implantation in Ningbo No.2 Hospital from November 2015 to November 2017. During the follow-up, the improvement of blood flow was evaluated, the occurrence of post-thrombotic syndrome was assessed by the Villalta rating scale, and the stent patency was examined with lower extremity ultrasound or angiography. Results: The blood flow was significantly improved after procedure in all 70 patients, including 62 cases (88.6%) of grade Ⅲ clearance, 5 cases (7.1%) of grade Ⅱ clearance, and 3 cases (4.3%) of grade Ⅰ clearance. No significant complications occurred during the treatment. The patients were followed up for (15.0±2.5) months. During the follow-up, 64 patients (91.4%) had unobstructed stents, and 9 patients (12.8%) had post-thrombotic syndrome. Conclusion: PMT combined with stent implantation is effective in the treatment of acute iliac vein thrombosis with a high medium-and long-term stent patency rate.
Key words: Thrombolytic therapy/methods    Iliac vein    Acute disease    Venous thrombosis    Lower extremity/blood supply    Treatment outcome    Stents
收稿日期: 2018-06-05 出版日期: 2019-03-15
:  R654  
基金资助: 宁波市医疗卫生品牌学科-临床医学共建（心脏大血管诊疗中心）(PPXK2018-01);宁波第二医院重点学科项目(2016-57)
通讯作者: 郎德海     E-mail: 912195864@qq.com;13738868758@139.com
作者简介: 余钻标(1987-), 男, 硕士, 住院医师, 主要从事外周血管介入临床及基础研究; E-mail:912195864@qq.com; https://orcid.org/0000-0003-1764-5166
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引用本文:

余钻标,林作栋,郎德海. 经皮机械血栓清除联合支架植入治疗急性髂股静脉血栓形成患者中远期疗效评估[J]. 浙江大学学报（医学版）, 2018, 47(6): 623-627.

YU Zuanbiao,LIN Zuodong,LANG Dehai. Long-term efficacy of percutaneous mechanical thrombectomy combined with stent implantation in treatment of acute iliofemoral venous thrombosis. J Zhejiang Univ (Med Sci), 2018, 47(6): 623-627.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2018.12.10    或    http://www.zjujournals.com/med/CN/Y2018/V47/I6/623

图 1  急性下肢深静脉血栓形成患者术后对侧髂静脉经皮血栓清除和球囊扩张支架植入过程
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