摘要
目的 探讨下肢静脉切开成形联合支架成形术 (双成形术 )治疗慢性下肢深静脉血栓的临床应用价值。方法 慢性下肢深静脉血栓形成 17例 ( 17条肢体 )行股总静脉解剖、髂股静脉球囊扩张加支架成形 ,联合手术髂或股静脉切开或大隐静脉补片成形术。结果 所有 17例均复通成功 ,9例手术切开成形加支架成形 ,8例采用大隐静脉补片成形加支架成形。置入支架数平均 ( 2 1± 0 8)枚 /例。并发症 :髂外静脉破裂 1例 ,腹股沟血肿 2例 ,淋巴瘘 1例 ,一过性咳嗽、呼吸急促 1例。无导丝引致的穿孔、夹层 ,无严重肺梗死 ,无切口感染及术中术后死亡。术后所有病例均不同程度缓解病情 ,有效率 94 12 %,显效率 76 47%。术后 1个月复发 1例。结论 “双成形术”治疗慢性下肢深静脉血栓 ,保证了手术成功率和治疗的彻底性 ,拓展了腔内治疗的范围 ,值得进一步推广、研究。
Objective To discuss the feasibility of stent-angioplasty and operative-angioplasty (double-angioplasty) for chronic deep venous thrombosis (DVT) of the lower limbs. Methods Seventeen cases of chronic DVT (17 limbs) were treated with endovascular method,that is,common femoral vein incision and balloon, stent angioplasty,combined with iliac or femoral vein dissection and/or major saphenous vein patching angioplasty.Results The revascularization and deploying procedures were successful in all 17 cases.The incision-angioplasty and stent-angioplasty were applied to 9 cases,while the major saphenous vein angioplasty and stent-angioplasty were applied to 8 cases.Number of stents used in each case was 2.11±0.8.Complications:rupture of the iliac vein in 1 case,hematoma in the inguinal area in 2 cases,lympho-leakage in 1 case,temporary cough and dyspnea in 1 case.No perforation and dissection due to the advancement of the guard-wire or catheter,severe pulmonary thrombosis,infection of the incision or peri-operative death.Symptoms of all the patients diminished.The efficacy rate was 94.12%,while the significant efficacy rate was 76.47%.Recurrence occurred in 1 case in the second month after operation.Conclusion The application of double-angioplasty in the treatment of chronic DVT of the lower limbs ensures the success rate and thoroughness of the operation.Also it expands the indications of endovascular method.It is valuable for further evaluation and spreading.
出处
《中国实用外科杂志》
CSCD
北大核心
2003年第4期214-216,共3页
Chinese Journal of Practical Surgery
