介入联合手术治疗Cockett综合征合并股青肿
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周为民 E-mail:zrzwm@sina.com

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Combination of interventional and surgical treatment for patients with Cockett syndrome complicated with phlegmasia cerulea dolens
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    摘要:

    目的:探讨采用手术联合介入方法治疗Cockett综合征合并股青肿的疗效。 
    方法:对2005—2010年采取介入联合手术处理的5例Cockett综合征合并股青肿患者的临床资料进行回顾性分析。
    结果:5例患者均有典型股青肿表现,其足背动脉、胫后动脉搏动均消失,术前多普勒均提示左下肢深静脉无血流,术中DSA均提示左髂静脉受压狭窄,证实为Cockett综合征。5例患者均行下腔静脉滤器植入,股静脉切开取栓,左髂静脉球囊扩张,其中1例行支架植入,术后均给予抗凝、溶栓治疗。术后患者均恢复满意,足背动脉搏动恢复,下肢肿胀缓解,随访3个月至5年未见血栓复发及其他并发症。
    结论:采用介入联合手术治疗Cockett综合征合并股青肿疗效确切,效果好。

    Abstract:

    Objective:To investigate the effect of the combination of interventional and surgical treatment for patients with Cockett syndrome complicated with phlegmasia cerulea dolens (PCD).
    Methods:The clinical records of 5 patients with Cockett syndrome complicated with PCD undergoing the combined treatment from 2005 to 2010 were retrospectively analyzed.
    Results:Five patients manifested classical PCD with absence of pulsation of dorsalis pedis and posterior tibial arteries. The diagnosis of Cockett syndrome was confirmed by preoperative Doppler and intraoperative DSA, which showed no blood flow in the deep veins of the left lower extremity, and showed compression and stricture of the left iliac vein. All cases underwent inferior vena cava filter placement, left femoral vein incision and embolectomy, and balloon dilatation of the left iliac vein were performed; among them one received stent implantation. After operation, all cases were given anticoagulant and thrombolytic therapy. All patients recovered well, their dorsalis pedis artery pulsations were restored and lower limb swellings disappeared. Follow up (3 months to 5 years) showed no recurrent thrombosis or other complications occurred.
    Conclusions:The combined interventional and surgical  treatment of Cockett syndrome complicated with PCD is effective, and has good therapeutic results.

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周卫|周为民|黄亮|熊吉信|唐新华.介入联合手术治疗Cockett综合征合并股青肿[J].中国普通外科杂志,2011,20(6):579-581.
DOI:10.7659/j. issn.1005-6947.2011.06.006

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  • 收稿日期:2011-02-05
  • 最后修改日期:2011-05-31
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  • 在线发布日期: 2011-06-15