Cockett综合征的影像表现与综合治疗

目的探讨Cockett综合征的早期影像表现及相应治疗方法的选择。方法收集分析62例经左下肢增强CT检查诊断为Cockett综合征患者的临床资料,4例行内科保守治疗,36例行球囊扩张后支架置入28例,二期23例行大隐静脉高位结扎加抽剥术。21例合并深静脉血栓形成患者在滤器保护下行置管溶栓治疗,溶栓治疗后14例行球囊扩张,12例支架置入。术后所有患者随访8-12月。结果术后静脉曲张消失、溃疡愈合,色素沉着明显改善,21例患肢肿胀患者中,19例肿胀消失,2例明显减轻。结论左下肢静脉CT成像能明确Cockett综合征诊断,了解狭窄程度及血流路径特点,及时给予综合治疗能有效减少Cockett综合征后期并发症。

Comprehensive treatment and imaging performance of Cockett’s syndrome

Objective To study appropriate therapeutic strategies and early imaging performance of Cockett＇s syndrome.Methods 62 cases were diagnosed as Cockett＇s syndrome by enhanced CT scan.Among of them 4 cases accepted conservative treatment,percutaneous transluminal angioplasty（PTA） was performed in 36 cases and then 28 cases underwent endovascular stent implantation.Later,23 cases underwent saphenous vein ligation and stripping in secondstage.21 cases complicated with acute deep venous thrombosis（DVT） of left lower extremity were placed inferior vena cava filter secondly accepted indwelling catheter thrombolysis therapy.After catheter thrombolysis therapy,14 cases underwent percutaneous transluminal angioplasty and endovascular stent implantation in 12 cases.All the patients were follow-up for 8-12 months.Results The varicose veins of limbs disappeared,the ulcers healing and the skin hyperpigmentation clearly better.Lower limb swelling disappeared in 19 of 21 cases and obviously relieved in 2 cases.Conclusion The CT image of left lower extremity could clarify Cockett＇s syndrome diagnosis and evaluate the stenosis and hemodynamic change of the iliac and femoral vein.Timely comprehensive treatment for Cockett＇s syndrome could effectively reduce the later period complications of Cockett＇s syndrome.