标题：介入溶栓治疗LIVCS并发LDVT患者的效果及安全性研究

      作者：王辉 1，李诗城 1，岳江 1，卢翔 1，郭岚 2，刘锐 3    陕西省汉中市中心医院介入与血管外科 1、甲乳外科 2、超声医学科 3，陕西 汉中 723000

      卷次： 2023年34卷22期

      【摘要】 目的 研究介入溶栓治疗左髂静脉受压综合征(LIVCS)并发左下肢深静脉血栓形成(LDVT)患者的效果及安全性。方法 选择 2020年 1月至 2023年 1月汉中市中心医院收治的 90例LIVCS并发LDVT患者作为研究对象，按照随机数表法将患者分为观察组和对照组各 45例。对照组患者给予外周静脉溶栓治疗，观察组患者给予介入溶栓治疗。均治疗1周后，比较两组患者的临床疗效、治疗前后的患侧与健侧大小腿周径差、血流速度、受压处血管内径、血栓清除率，并统计两组患者的并发症发生率。结果 治疗后，观察组患者的治疗总有效率为97.78%，明显高于对照组的80.00%，差异有统计学意义(P<0.0.5)；治疗后，两组患者的患侧与健侧大、小腿周径差均明显降低，且观察组患者患侧与健侧大腿和小腿周径差分别为(1.88±0.43) cm、(1.84±0.36) cm，明显低于对照组的(2.67±0.58) cm、(2.71±0.67) cm，差异均有统计学意义(P<0.05)；观察组患者受压处血管内径、血栓清除率分别为(4.57±0.33) mm、(66.74±2.52)%，高于对照组的(4.16±0.23) mm、(61.42±2.31)%，血流速度为(60.18±7.17) cm/s，明显低于对照组的(66.26±7.26) cm/s，差异均有统计学意义(P<0.05)；治疗后，观察组患者的并发症发生率为8.89%，明显低于对照组的24.44%，差异有统计学意义(P<0.05)。结论 介入溶栓治疗LIVCS并发LDVT疗效确切，可有效改善患者下肢肿胀情况，调节血管狭窄闭塞，降低血栓水平，且并发症发生率低，安全可靠。
      【关键词】 左髂静脉受压综合征；左下肢深静脉血栓形成；血栓；介入溶栓；并发症
      【中图分类号】 R442.8 【文献标识码】 A 【文章编号】 1003—6350（2023）22—3233—04

Efficacy and safety of interventional thrombolysis in the treatment of patients with left iliac vein compressionsyndrome complicated with left lower limb deep vein thrombosis.WANG Hui 1, LI Shi-cheng 1, YUE Jiang 1, LU Xiang 1,GUO Lan 2, LIU Rui 3.
Department of Interventional and Vascular Surgery 1, Department of Nail and Breast Surgery 2,Department of Ultrasound Medicine 3, Hanzhong Central Hospital, Hanzhong 723000, Shaanxi, CHINA
【Abstract】 Objective To explore the efficacy and safety of interventional thrombolysis in the treatment ofleft iliac vein compression syndrome (LIVCS) complicated with left lower limb deep vein thrombosis (LDVT).Methods Ninety patients with LIVCS complicated with LDVT admitted to Hanzhong Central Hospital from January2020 to January 2023 were selected as the study subjects, which were randomly divided into an observation group and acontrol group, each with 45 cases. Patients in the control group were treated with peripheral venous thrombolysis, whilethose in the observation group were treated with interventional thrombolysis. After one week of treatment, clinical effica-cy, the difference in leg circumference, blood flow velocity, vascular diameter at the compression site, and thrombusclearance rate between the affected and healthy sides of the two groups of patients were compared before and after treat-ment, and the incidence of complications in the two groups was counted. Results After treatment, the total effectiverate of the observation group was 97.78%, which was significantly higher than 80.00% in the control group (P<0.05). Af-ter treatment, the difference in circumference between the affected and healthy sides of the thigh and calf in the observa-tion group were (1.88±0.43) cm and (1.84±0.36) cm, which were significantly lower than (2.67±0.58) cm and (2.71±0.67) cm in the control group (P<0.05). The blood vessel diameter and thrombus clearance rate at the compression site inthe observation group were (4.57±0.33) mm and (66.74±2.52)%, which were significantly higher than (4.16±0.23) mmand (61.42±2.31)% in the control group; the blood flow velocity was (60.18±7.17) cm/s, which was significantly lowerthan (66.26±7.26) cm/s in the control group; the differences were statistically significant (P<0.05). After treatment, theincidence of complications in the observation group was 8.89%, which was significantly lower than 24.44% in the con-trol group (P<0.05). Conclusion Interventional thrombolysis for the treatment of LIVCS complicated with LDVT hasa definite therapeutic effect, which can effectively improve the swelling of patients' lower limbs, regulate vascular steno-sis and occlusion, reduce thrombus levels, and have a low incidence of complications, which is safe and reliable.
      【Key words】 Left iliac vein compression syndrome; Left lower limb deep vein thrombosis; Thrombus; Interven-tional thrombolysis; Complication