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

目的 探讨顺行静脉造影在非血栓性髂静脉受压综合征（NIVCS）中的诊断价值。方法 回顾性分析2004年1月—2006年12月于上海交通大学医学院附属第九人民医院血管外科经左下肢顺行静脉造影诊断的NIVCS（A组＋B组）和原发性下肢静脉慢性功能不全（CVI）患者（C组）的病例资料，NIVCS患者均经静脉CT血管造影（CTA）检查确诊。A组采用受压髂静脉球囊扩张联合支架植入术和曲张浅静脉腔内激光（EVLA）治疗，B组和C组均接受EVLA治疗，随访比较各组疗效。结果 顺行静脉造影检查共发现91例NIVCS患者（A组39例，B组52例）和554例原发性CVI患者（C组）。随访1～24个月，A组和C组疗效确切，而B组效果欠佳。结论 顺行静脉造影诊断NIVCS的特异性高，对NIVCS患者治疗方法的选择具有较高的临床应用价值，即顺行静脉造影诊断的NIVCS患者在治疗浅静脉返流的同时常需处理髂静脉的回流障碍。

Value of ascending venography in diagnosis of nonthrombotic iliac vein compression syndrome

Objective To determine the value of ascending venography in diagnosis of nonthrombotic iliac venous compression syndrome (NIVCS). Methods From January 2004 to December 2006, the clinical data of patients with NIVCS (group A + group B) and those with primary chronic venous insufficiency (CVI) in the left lower extremity (group C) diagnosed with ascending venography were retrospectively analysed. The diagnosis of NIVCS was confirmed by venous CT angiography (CTA). Patients in group A were treated with angioplasty and stent placement combined with endovascular laser ablation (EVLA), and those in group B and group C were treated with EVLA only. Patients were followed up and therapeutic effects were compared. Results Ninety-one patients with NIVCS (n=39 in group A and n=52 in group B) and 554 patients with primary CVI in the left lower extremity (group C) were diagnosed by ascending venography. Patients in group A and group C experienced a significant symptom relief, while those in group B did not. Conclusion The specificity of ascending venography is high in diagnosis of NIVCS, and ascending venography also plays a role in guiding the treatment. It is advised that patients diagnosed by ascending venography need treatment for the venous outflow occlusion and EVLA for the venous reflux.