中国实用外科杂志

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下肢深静脉血栓后综合征的腔内治疗

王鹏辉,董智慧   

  1. 复旦大学附属中山医院血管外科 复旦大学血管外科研究所 国家放射与治疗临床医学研究中心,上海200032
  • 出版日期:2023-12-01

  • Online:2023-12-01

摘要: 下肢深静脉血栓后综合征(PTS)是下肢深静脉血栓形成病人的主要中远期并发症。压力治疗、药物治疗和功能锻炼等保守治疗已成为PTS病人的基本疗法,但部分中重度PTS病人接受保守治疗后症状改善不明显,迫切需要外科干预。随着腔内介入器械和技术的不断发展,腔内治疗成为中重度PTS病人的首选手术方式。然而,在PTS腔内治疗临床应用中,对于手术适应证、操作技术要点及疗效评估等方面的认识相对不足。临床医生应严格把握腔内治疗的手术指征、规范术中操作、加强术后管理,以提高腔内治疗的远期疗效。此外随着PTS腔内治疗的不断开展,研发符合静脉生理和解剖条件的静脉支架对于提高PTS病人治疗效果具有重大意义。

关键词: 血栓形成后综合征, 深静脉血栓形成, 腔内治疗

Abstract: Endovascular therapy of post-thrombotic syndrome                  WANG Peng-hui, DONG Zhi-hui. Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
Corresponding author: DONG Zhi-hui, E-mail:dong.zhihui@
zs-hospital.sh.cn
Abstract    Post-thrombotic syndrome (PTS) is a major medium-to-long-term complication in patients with lower extremity deep vein thrombosis. Conservative treatment, including compression treatment, pharmacotherapy, and exercise training, has become the cornerstone for the treatment of PTS, but the symptoms of some patients do not improve significantly after conservative treatment and surgical intervention are urgently needed. With the development of interventional equipment and technology, endovascular therapy has become the first choice for moderate and severe PTS patients. However, the understanding of surgical indications, operational technical points, and efficacy evaluation is relatively insufficient in the endovascular therapy of PTS. In order to improve the long-term effect of endovascular therapy in pts, surgeons should strictly consider the operative indications, standardize the intraoperative operation, and strengthen postoperative management. In addition, the research and development of dedicated venous stents that meet the physiological and anatomical conditions of veins are of great significance for improving the therapeutic effect of PTS patients.

Key words: post-thrombotic syndrome, deep vein thrombosis, endovascular therapy