摘要 目的探讨急性髂股静脉血栓合并Cockett综合征术后支架闭塞的高危因素。方法回顾性分析2014年1月至2016年12月在本院诊治的178例Cockett综合征合并急性下肢深静脉血栓形成患者的临床资料。患者均行下肢深静脉导管溶栓或者机械吸栓联合支架置入术。术后随访3年以上,使用彩超随访支架通畅率。根据支架通畅情况将患者分为试验组(支架闭塞)及对照组(支架通畅),记录患者基本信息、现病史、既往史、血栓等信息,采用Logistic回归分析术后短期及中期支架闭塞的高危因素。结果随访6个月支架通畅率为83.7%,体质量指数(OR=1.245,95%CI:1.097~1.413)、病程>2周(OR=3.899,95%CI:1.147~13.257)、血栓清除率低(OR=0.238,95%CI:0.117~0.486)是术后短期支架闭塞的高危因素。3年支架通畅率为75.3%,体质量指数(OR=1.225,95%CI:1.076~1.394)、病程>2周(OR=11.777,95%CI:2.576~53.832)、肿瘤(OR=4.444,95%CI:1.153~17.127)、弹力袜治疗(OR=0.332,95%CI:0.113~0.977)、血栓清除率低(OR=0.184,95%CI:0.089~0.381)、长段支架(OR=8.427,95%CI:2.329~30.488)是术后中期支架闭塞的高危因素。结论肥胖、血栓病程>2周、血栓清除率低是支架早期闭塞的高危因素,而肿瘤、未正规压力治疗以及髂股静脉长段支架可能导致支架的中远期通畅率降低。 Objective To evaluatte the high risk factors of stent occlusion in patients with acute iliofemoral vein thrombosis and Cockett syndrome.Methods The clinical data of 178 patients of Cockett syndrome and acute lower extremity deep vein thrombosis from Jan 2014 to Dec 2016 was analyzed retrospectively.All patients underwent catheter directed thrombolysis or percutaneous mechanical thrombectomy combined with stent placement.The patency rate of stent was followed up by color Doppler ultrasound.Patients were divided into study group(stent occlusion)and control group(stent patency).Results The stent patency rate at 6 months was 83.7%,body mass index(OR=1.245,95%CI:1.097-1.413),time of thrombosis more than 2 weeks(OR=3.899,95%CI:1.147-13.257),low thrombus clearance(OR=0.238,95%CI:0.117-0.486)was the high risk factor of short-term stent occlusion.Stent patency rate at 3 years was 75.3%,body mass index(OR=1.225,95%CI:1.076-1.394),thrombosis history more than 2 weeks(OR=11.777,95%CI:2.576-53.832),malignant tumor(OR=4.444,95%CI:1.153-17.127),compression therapy(OR=0.332,95%CI:0.113-0.977),low thrombus clearance(OR=0.184,95%CI:0.089-0.381),long stents(OR=8.427,95%CI:2.329-30.488)was the high risk factor for mid-term stent occlusion.Conclusions Obesity,the duration of thrombus longer than 2 weeks and low thrombus clearance are the high risk factors of early stent occlusion,while malignant tumor,irregular compression therapy and long stents may lead to lower medium and long term patency rate of the stent.
出处 《中华普通外科杂志》 CSCD 北大核心 2021年第4期290-294,共5页 Chinese Journal of General Surgery
基金 上海市自然科学基金(17ZR1405600) 上海市青浦区卫健委项目(W2019-39)。
分类号 R47 [医药卫生—护理学]
