性腺静脉机械化学静脉内闭塞术(1例报告)。

R V Akhmetzianov, R A Bredikhin, S M Markin, M Yu Volodyukhin
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引用次数: 0

摘要

本文报告一位42岁女性患者,因骨盆静脉过多表现而行机械化学封堵性腺静脉的临床病例。检查显示原发性盆腔静脉曲张,伴有左侧卵巢和子宫静脉扩张,双侧旁膝神经丛静脉扩张。在x线手术室条件下,将Flebogrif机械消融装置插入卵巢左静脉腔内。适当应用该装置并同时施用硬化剂导致静脉壁的机械和化学损伤。这样得到的结果是停止腔内血流。术后3、6、12、24个月复查。经临床和仪器检查证实,静脉回流减少,盆腔血流动力学正常化,临床症状好转。本病例报告证明了该手术的可行性、有效性和安全性。该机械化学方法的发展,使妇女盆腔静脉曲张手术治疗的结果有可能改善,因为它没有一系列固有的缺点,传统类型的血管内治疗涉及以栓塞微线圈的形式植入外来物质。为了证实这一假设,有必要进行有足够数量患者参与的随机比较试验。
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[Mechanochemical endovenous obliteration of the gonadal vein (case report)].

Presented herein is a clinical case report regarding mechanochemical obliteration of the gonadal vein in a 42-year-old female patient suffering from manifestations of pelvic venous plethora for 6 previous years. The examination revealed a primary form of pelvic varicose disease with dilatation of the left ovarian and uterine veins, bilateral veins of the pampiniform plexus. In conditions of the X-ray operating room, inserted into the lumen of the left ovarian vein was the Flebogrif device for mechanical ablation. Appropriate application of the device with simultaneous administration of a sclerosing agent resulted in mechanical and chemical damage of the venous wall. The outcome thus obtained was cessation of intraluminal blood flow. The woman was examined at 3, 6, 12 and 24 months postoperatively. Reduction of venous reflux was accompanied by normalization of pelvic phlebohemodynamics and regression of clinical symptomatology, confirmed by clinical and instrumental methods of examination. This case report demonstrates feasibility, efficacy and safety of the procedure performed. The developed mechanochemical method makes it possible to improve outcomes of surgical treatment of women with pelvic varicose veins, since it is devoid of a series of disadvantages intrinsic to the traditional type of endovascular treatment involving implantation of foreign material in the form of embolizing microcoils. To confirm this hypothesis, it is necessary to carry out randomized comparative trials with participation of a sufficient number of patients.

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