血管内支架治疗髂股静脉血栓形成后综合征的疗效分析

目的探讨血管内支架治疗髂股静脉血栓形成后综合征（PTS）的临床疗效。方法回顾性分析27例髂股静脉PTS病人的病例资料，静脉再通后置入支架，随访半年，采用Villalta评分和慢性静脉功能不全问卷（CIVIQ-20）评价治疗前后PTS的严重程度和生活质量。结果全部病人术后即刻静脉均成功再通；随访半年后，一期通畅率、辅助通畅率和二期通畅率分别为66.7%（18/27）、77.8%（21/27）和88.9%（24/27）。Villalta评分从术前的（17.44±5.49）分，在随访半年后降到（5.78±3.31）分（P<0.01），CIVIQ-20评分从（37.26±10.89）分升至（58.93±12.91）分（P<0.01），术后半年随访严重程度明显低于术前（P<0.01）；logistic回归分析显示，术前Villalta和CIVIQ-20评分、年龄是Villalta增益相关的独立影响因素（P<0.05~P<0.01），术前Villalta评分是CIVIQ-20增益相关的独立影响因素（P<0.05）。结论血管内支架对髂股静脉PTS的治疗有效，能降低PTS的严重程度，改善病人的生活质量。

The efficacy of endovascular stent in the treatment of iliofemoral post-thrombosis syndrome

ObjectiveTo investigate the clinical effects of endovascular stent in the treatment of iliofemoral post-thrombosis syndrome(PTS).MethodsThe clinical data of 27 patients with iliofemoral PTS were analyzed retrospectively.After venous recanaliztion and self-expandable stenting, the patients were followed up for 6 months.The severity of PTS and quality of life before and after treatment were evaluated using Villalta score and chronic venous insufficiency questionnaire(CIVIQ-20) scale.ResultsAll patients were successfully recanalized after operation.After 6 months fo following-up, the primary patency rate, assisted patency rate and secondary patency rate were 66.7%(18/27), 77.8%(21/27) and 88.9%(24/27), respectively.The Villalta score decreased from(17.44±5.49) before operation to(5.78±3.31) after operation(P<0.01), while the CIVIQ-20 scores increased from(37.26±10.89) to(58.93±12.91)(P<0.01).The severity of postoperative half-year follow-up was significantly lower than that before surgery(P<0.01).The results of logistic regression analysis showed that the preoperative Villalta and CIVIQ-20 scores, and age were the independent factors related to the Villalta gain, and the preoperative Villalta was the independent factors related to the CIVIQ-20 gain.ConclusionsThe endovascular stent in the treatment of iliofemoral PTS is effective, which can reduce the severity of PTS and improve the quality of life.