合并Cockett综合征的急性下肢深静脉血栓形成患者髂静脉扩张成形时机对导管直接溶栓持续时间的影响

目的探讨合并Cockett综合征的急性下肢深静脉血栓形成（deep vein thrombosis，DVT）患者髂静脉扩张成形时机对导管直接溶栓持续时间的影响。方法回顾性分析38例急性DVT合并Cockett综合征患者的临床资料，根据髂静脉扩张成形和导管直接溶栓的先后顺序，分为导管直接溶栓前扩张髂静脉狭窄（n=14，A组）与导管直接溶栓过程中或溶栓后扩张髂静脉狭窄（n=24，B组）2组，比较溶栓时间、溶栓效果以及扩张局部出血情况。结果A组溶栓时间（25．79±18．23）h，B组（46．83±23．36）h，差异有显著性（t=-2．891，P=0．006），2组溶栓效果差异无显著性（P〉0．05）。结论介入治疗急性下肢深静脉血栓形成合并Cockett综合征时，髂静脉扩张成形在导管直接溶栓之前实施能够显著缩短溶栓时间，且不增加出血风险。

Timing of Iliac Vein Dilation Formation for Acute Lower Limb Deep Venous Thrombosis Complicated with Cockett Syndrome and Its Effect on the Duration of Catheter-directed Thrombolysis

Objective To investigate the timing of iliac vein dilatation formation for acute deep venous thrombosis （DVT） complicated with Cockett syndrome, and its effect on the duration of catheter directed thrombolysis. Methods A retrospective analysis on 38 patients with acute DVT complicated with Cockett syndrome. The patients were divided into groups A and B according the order of dilatation formation and catheter-directed thrombolysis. In group A （ n = 14 ） , the iliac vein dilation formation was performed before thrombolysis, while in group B （ n = 24 ） , the thrombolysis was carried out before the dilation formation. The duration and results of catheter-directed thrombolysis, as well as local hemorrhage at the dilation site were compared between the two groups. Results Group A showed significantly shorter duration of catheter-directed thromboiysis than that in group B （25.79 ±18.23 ） h vs. （46.83 ±23.36） h, t = - 2. 891, P = 0. 006], however no significant difference was detected in the results of the thrombolysis. Conclusion Iliac vein dilatation formation followed by catheter-directed thrombolysis can reduce the duration of thrombolysis for patients with acute DVT complicated with Cockett syndrome, without increase the risk of hemorrhage.