一站式杂交手术治疗髂静脉压迫综合征合并下肢静脉曲张的疗效分析

目的：探讨一站式杂交手术治疗髂静脉压迫综合征（IVCS）合并下肢静脉曲张的临床效果及安全性。 方法：选取2013年8月至2017年7月我院收治的IVCS合并下肢静脉曲张患者91例，按照治疗方式不同分为两组：49例同期行髂静脉狭窄及曲张静脉手术（一站式杂交手术组），42例先行髂静脉成形术，二期行曲张静脉手术（分期手术组）。比较两组的临床疗效（髂静脉一期通畅率、溃疡愈合率及肿胀缓解率）、经济负担（住院天数、总费用）及安全性（并发症）。 结果：两组患者的12个月髂静脉一期通畅率（100% vs. 100%）、溃疡愈合率（100% vs. 100%）及肿胀缓解率（87.50% vs. 88.89%）差异均无统计学意义（P>0.05）；一站式杂交手术组患者的住院总费用（3.77±0.32）万元vs.（4.37±0.20）万元]和住院天数（13.50±2.30）d vs.（16.61±3.28）d]均低于分期手术组，差异有统计学意义（t=-9.52、-4.62，P均<0.01）；两组的并发症主要为腹股沟区出血及皮下大面积淤血，并发症发生率差异无统计学意义6.12%（3/49）vs. 4.76%（2/42），P>0.05）]，予以相应处理后均好转；两组均无下肢深静脉血栓形成、肺栓塞及支架内血栓形成发生。 结论：IVCS合并下肢静脉曲张行一站式杂交手术治疗，近期疗效好，具有微创、住院时间短、总费用低等优点，值得临床推广开展。

Efficacy analysis of one-stop hybrid operation on iliac vein compression syndrome combined with lower extremity varicose veins

Objective:To evaluate the efficacy and safety of one-stop hybrid operation on iliac vein compression syndrome (IVCS) combined with lower extremity varicose veins. Methods:The clinical data of 91 patients diagnosed with IVCS combined with lower extremity varicose veins from August 2013 to July 2017 were analyzed. All the cases were divided into two groups according to different treatments, 49 cases underwent IVCS and lower extremity varicose veins operation at the same time (one-stop hybrid operation group, group A) , and 42 cases were firstly operated with IVCS, then underwent lower extremity varicose vein operation during a hospital stay (state operation group, group B) . Results:There was no significant difference in iliac vein primary patency rate, ulcer healing rate and swelling relief rate at 12 months in the two groups (100% vs. 100%) , (100% vs. 100%) , (87.50% vs. 88.89%) , P>0.05]. The difference in hospitalization days and expenses (13.50±2.30) vs. (16.61±3.28) d, (37.7±3.2) vs. (43.7±2.0) thousand Yuan, P<0.05] was statistically significant. Complications were mainly inguinal bleeding and hypodermic blood stasis with corresponding improvement after symptomatic treatment, so there was no statistically significant difference 6.12% (3/49) vs. 4.76% (2/42) , P>0.05]. There were no deep venous thrombosis, pulmonary embolism, stent thrombosis, etc occurring in the two groups. Conclusions:One-stop hybrid operation for IVCS combined with lower extremity varicose veins has good short-term efficacy, less invasive, short hospital stay and low cost, which is worthy of clinical promotion.