Iliac Vein Compression Syndrome (IVCS): An Under-Recognized Risk Factor for Left-Sided Deep Venous Thrombosis (DVT) in Old Hip Fracture Patients.
Iliac Vein Compression Syndrome (IVCS): An Under-Recognized Risk Factor for Left-Sided Deep Venous Thrombosis (DVT) in Old Hip Fracture Patients.
复制标题
髂静脉受压综合征 (IVCS)：老年髋部骨折患者左侧深静脉血栓 (DVT) 的一个未被充分认识的危险因素
DOI：
10.12659/msm.901639
复制
发表时间：
2017-05-01
期刊：
影响因子：
--
通讯作者：
Wu X
中科院分区：
文献类型：
--
作者：
Liu J;Liu P;Xia K;Chen L;Wu X
本研究的目的是确定髂静脉压迫综合征（IVCS）是否是髋部骨折患者左侧深静脉血栓形成（DVT）的危险因素，以及IVCS对DVT治疗的影响。材料/方法回顾性分析2011 - 2016年我院收治的424例髋部骨折患者的临床资料。根据血浆D-二聚体浓度和左下肢多普勒超声检查结果将患者分为DVT组和非DVT组。此外，静脉造影图像中左髂静脉50%管腔内狭窄被认为是IVCS。比较DVT组与非DVT组IVCS的患病率。DVT组患者进一步分为DVT+/IVCS+组和DVT+/IVCS−组，以评价IVCS可能对DVT治疗的影响。结果DVT组204例，非DVT组220例。两组之间的平均年龄、性别分布、骨折类型和伴随的危险因素无统计学显著差异。DVT组中共有70例（34.3%）患者被诊断为IVCS，而非DVT组中有52例（23.6%）患者被确诊为IVCS（P=0.02）。术后，DVT+/IVCS+组和DVT+/IVCS−组中症状性DVT的发生率分别为30.0%和11.9%（P=0.002）。结论IVCS是髋部骨折患者发生左侧DVT的一个未被充分认识的危险因素。此外，当DVT合并IVCS时，单纯抗凝治疗是不够的。必须采取更积极的措施来取得有利的结果。
Background The aim of this study was to identify whether iliac vein compression syndrome (IVCS) is a risk factor for left-sided deep venous thrombosis (DVT) in hip fracture patients and the influence IVCS may have on the treatment of DVT. Material/Methods A retrospective study was carried out among 424 hip fracture patients admitted to our hospital from 2011 to 2016. Clinical data were analyzed, and all patients were classified into the DVT group and the non-DVT group based on plasmin D-Dimer concentration and results of Doppler ultrasound of the left lower limb. Also, a 50% intraluminal constriction of the left iliac vein in the venography image was considered as IVCS. Comparison of IVCS prevalence was made between the DVT group and the non-DVT group. Patients in the DVT group were further divided into the DVT+/IVCS+ group and the DVT+/IVCS− group to evaluate the influence IVCS may have on the treatment of DVT. Results There were 204 patients in the DVT group and 220 patients in the non-DVT group. No statistically significant differences were found regarding the mean age, sex distribution, fracture type, and accompanying risk factors between the two groups. A total of 70 patients (34.3%) were diagnosed with IVCS in the DVT group, while confirmed IVCS was found in 52 patients (23.6%) in the non-DVT group (P=0.02). Postoperatively, the incidence of symptomatic DVT in the DVT+/IVCS+ group and the DVT+/IVCS− group was 30.0% and 11.9%, respectively (P=0.002). Conclusions IVCS is an under-recognized risk factor for left-sided DVT in hip fracture patients. What’s more, anticoagulation alone is insufficient for the treatment of DVT when it is complicated with IVCS. More aggressive measures have to be taken to achieve a favorable outcome.