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[目的]探讨髂静脉压迫综合征合并深静脉血栓介入治疗的方法及效果。[方法]102例左下肢深静脉血栓合并髂静脉压迫综合征患者进行深静脉插管,尿激酶接触性溶栓治疗,常规经右侧股静脉或经右颈静脉入路,如插管困难,则采用辅助性插管技术,包括同轴导管技术、翻山鞘技术、或经患(左)侧股静脉插管,44例放置了永久或临时下腔静脉滤器,尿激酶用量360万～1400万单位,34例行髂股静脉狭窄球囊扩张,9例行支架植入。[结果]对常规插管困难的病例采用辅助性插管技术后,左髂股静脉插管总成功率为96.1%,下肢肿胀症状完全消失78例(76.5%),肿胀症状改善的24例(23.5%)。[结论]髂静脉压迫综合征合并深静脉血栓介入治疗中,辅助性插管技术是安全有效的方法,能够提高插管成功率。髂静脉压迫综合征导致狭窄或闭塞,如侧支循环充分,不需特殊处理。
[Objective] To explore the method and effect of interventional treatment of iliac vein compression syndrome complicated with deep vein thrombosis. [Method] 102 cases of deep vein thrombosis with iliac vein compression syndrome were treated with deep vein catheterization and urokinase-contact thrombolytic therapy. Conventional right femoral vein or right jugular vein approach included difficulty in intubation, The use of complementary intubation techniques, including coaxial catheter technology, overlying sheath technique, or by the affected (left) side of the femoral vein catheterization, 44 cases placed a permanent or temporary IVC filter, the amount of urokinase 3.6 million ~ 1400 Thirty thousand units, 34 cases of iliofemoral vein stenosis balloon dilation, 9 cases of stent implantation. [Result] The results showed that the total success rate of left iliac vein femoral cannulation was 96.1%, 78 cases (76.5%) disappeared completely, the symptoms of swelling were improved in 24 cases 23.5%). [Conclusion] In iliac vein compression syndrome complicated with deep vein thrombosis interventional therapy, adjuvant intubation is a safe and effective method, which can improve the success rate of intubation. The iliac vein compression syndrome leads to stenosis or occlusion, such as full collateral circulation, without special treatment.