摘要
目的探讨Cockett综合征继发下肢静脉曲张或下肢肿胀的治疗方法及疗效。方法 2014年3月~2015年3月我科对25例经血管造影明确诊断的Cockett综合征（继发下肢静脉曲张22例,下肢肿胀3例）行髂静脉经皮腔内血管成形术（percutaneous transluminal angiography,PTA）,19例支架置入,22例静脉曲张二期行大隐静脉高位结扎联合点式剥脱术。结果 25例均行髂静脉PTA,下肢静脉曲张17例行髂静脉支架置入,下肢肿胀2例行髂静脉支架置入。22例下肢静脉曲张介入术后1个月行下肢大隐静脉高位结扎联合点式剥脱术。术后无明显下肢肿胀、下肢感染、深静脉血栓形成等并发症。术后1个月随访下肢肿胀治愈20例,好转5例。25例随访3~15个月,平均12.4月,无一例出现下肢明显肿胀、下肢静脉曲张复发及下肢深静脉血栓形成。结论 Cockett综合征行髂静脉PTA,根据髂静脉狭窄情况决定是否行支架置入,术后下肢肿胀能够明显缓解,对于继发下肢静脉曲张的患者1个月后再行大隐静脉高位结扎联合点式剥脱术,手术效果显著。
Objective To explore the treatment method and curative effect for lower limb varicose vein or swelling secondary to Cockett syndrome. Methods From March 2014 to March 2015,a total of 25 cases of lower limb varicose vein（ 22 cases） or swelling（ 3 cases） secondary to Cockett syndrome were treated with percutaneous transluminal angiography（ PTA）. Stents were placed in the veins in 19 cases,and 22 patients with varicose veins were treated with the great saphenous vein high ligation and point type stripping at secondary stage. Results The operations were successful. The iliac vein PTA was performed in all the 25 patients. The iliac vein stent implantation was performed in 17 cases of varicose veins and 2 cases of lower limb swelling. The saphenous vein high ligation and point type stripping was performed in 22 cases of varicose veins of lower extremity at 1 month after the interventional treatment. Postoperatively,no complications such as lower limb swelling,infection,or deep vein thrombosis occurred. Follow-up at the first postoperative month showed 20 cases of cured and 5 cases of alleviated. Follow-up for 3- 15 months（ mean,12. 4 months） in the25 cases showed no lower limb swelling,recurrence of varicose vein,or deep vein thrombosis. Conclusions Cockett syndrome patients can be treated with iliac vein PTA. Whether or not a stent placement is required is determined according to the extent of vein stenosis. Postoperatively,lower limb swelling can be significantly alleviated. For patients with secondary varicose vein of lower extremity,saphenous vein ligation and point type stripping is recommended after 1 month.
出处
《中国微创外科杂志》
CSCD
北大核心
2016年第5期428-431,共4页
Chinese Journal of Minimally Invasive Surgery
