下肢静脉造影在下肢静脉曲张患者中的应用及阻塞性下肢静脉曲张发生的预测因素

目的 探讨下肢静脉造影检查在下肢静脉曲张中应用的临床意义,并分析阻塞性下肢静脉曲张可能相关的预测因素.方法 选取2019年1月至2021年12月因下肢静脉曲张于海军军医大学第二附属医院诊治的74例患者(111条患肢)为研究对象,对所有患肢行下肢静脉造影检查,采用病例报告表形式记录患者相关信息,根据有无深静脉阻塞表现分为...

Application of lower extremity venography in patients with lower extremity varicose vein and predictors of obstructive lower extremity varicose vein

Objective To investigate the clinical significance of lower extremity venography in lower extremity varicose vein,and to analyze the possible predictors of obstructive lower extremity varicose vein.Method A total of 74 patients(111 limbs)who were admitted to the vascular surgery of the Second Affiliated Hospital of Naval Military Medical University from January 2019 to December 2021 were selected as the research objects.All limbs underwent lower extremity venography.The relevant information of patients was recorded in the form of case report form and the patients were divided into obstructive group and reflux group according to the presence or absence of deep vein occlusion to analyze the possible predictors of obstructive lower extremity varicose veins.Result All 74 patients with lower extremity varicose veins successfully completed anterograde venography,and there were no adverse reactions such as iodine contrast agent allergy.The results showed that among 111 affected limbs,86 had reflux varicose veins,including 35 primary superficial varicose veins and 51 primary deep venous insufficiency;25 had obstructive varicose veins,including 7 iliac vein compression syndrome and 18 post-thrombotic syndrome.Multivariate logistic regression analysis showed that lower extremity varicose limbs with CEAP grade C4 and above had a lower risk of being diagnosed as obstructive lower extremity varicose veins than those with CEAP grade C3 and below(OR=0.071,95%CI:0.011-0.460,P=0.006),Lower extremity varicose veins with depressed edema had a higher risk of being diagnosed as obstructive lower extremity varicose veins than those without depressed edema(OR=256.989,95%CI:27.223-2425.981,P<0.01),lower extremity varicose veins with abnormal prothrombin time had a higher risk of being diagnosed as obstructive lower extremity varicose veins than those with normal prothrombin time(OR=11.608,95%CI:1.565-86.099,P=0.017).Conclusion Lower extremity venography has guiding significance in the diagnosis and differential diagnosis of lower extremity varicose veins.It is recommended that patients with lower extremity varicose veins combined with above C4 level,pitting edema or abnormal prothrombin time should be examined by lower extremity venography before operation to eliminate the possibility of obstructive lower extremity varicose vein.