急性左下肢深静脉血栓形成合并Cockett综合征的治疗

目的 探讨急性左下肢深静脉血栓形成(DVT)合并Cockett综合征(CS)的有效治疗方法.方法 回顾性分析2004年8月-2008年1月收治16例急性左下肢DVT合并CS的临床资料.16例均行下腔静脉滤器置人术及左下肢股静脉切开取栓术,其中13例患者同时行左髂总静脉PTA及支架置入术,另3例行PTA术,术后均予抗凝,祛聚,溶栓治疗.结果 全组无手术死亡及肺栓塞的发生,14例患者取得了满意的疗效.16例中2例术后第2天再发生左下肢急性血栓形成,予药物抗凝、溶栓、祛聚治疗,出院时肢体肿胀明显好转.随访14例,随访时间1～25个月(平均11个月),2例出现下肢DVT后综合征,余12例左下肢无肿胀,无静脉曲张及色素沉着.结论 急性左下肢DVT并CS行手术取栓加左髂总静脉PTA术及支架置入术可获得满意疗效.

Treatment of acute deep venous thrombosis of left lower extremity accompanied with Cockett syndrome

Objective:To explore the effective treatment of acute deep venous thrombosis(DVT) of left lower extremity accompanied with Cockett syndrome. Methods :The data of 16 patients with acute DVT of left lower extremity accompanied with Cockett syndrome, who were admitted to our hospital from August,2004 to January,2008, were analyzed retrospectively. Inferior vena caval filters were inserted and thrombectomy was done to all of the 16 patients; PTA and stent insertion were done in 13 patients and PTA only in the other 3 patients. Anticoagulation, thrombolysis and antiplatelet therapy were given postoperatively to all the patients. Results:There was no death or pulmonary embolism in all 16 patients; Forteen patieats had good outcome, 2 had acute DVT of left lower extremity one day after surgery, and limbs swelling subsided after anticoagulation, thrombolysis and antiplatelet treatment before their discharge. Forteen patients were followed up from 1 month to 25 months(average 11 months),and 2 patients had post-DVT syndrome, but the others had no swelling or varicose veins of the lower extremity. Conclusions:Most patients with acute DVT of left lower extremity accompanied with Cockett syndrome could get satisfactory outcome with thrombectomy,PTA and stent insertion.