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盆腔淤血综合征的压迫治疗

Compression treatment of pelvic congestion syndrome.

作者信息

Gavrilov S G, Karalkin A V, Turischeva O O

机构信息

1 Department of Faculty Surgery No 1, Pirogov Russian National Research Medical University, Moscow, Russia.

2 First City Hospital of Moscow, Moscow, Russia.

出版信息

Phlebology. 2018 Jul;33(6):418-424. doi: 10.1177/0268355517717424. Epub 2017 Jun 22.

Abstract

Aim To study the influence of compression treatment on clinical manifestations and venous hemodynamics of the pelvis in patients with pelvic congestion syndrome. Materials and methods A prospective study of the various options and modes of compression treatment was carried out and included 74 patients with pelvic congestion syndrome in 2008-2015. The patients were divided into three groups. The first group consisted of 48 patients with symptoms of pelvic congestion syndrome and chronic pelvic pain. They used Class II compression shorts. In the second group, there were 14 patients with pelvic congestion syndrome, vulvar varicosities without pelvic pain. They used Class II compression shorts and stockings. In the third group, 12 women with pelvic congestion syndrome and chronic pelvic pain used only the Class II compression stockings. The treatment continued for 14 days. A clinical criterion was the change of severity of chronic pelvic pain. The evaluation of the treatments has been performed using radionuclide venography and emission computed tomography with labeled in vivo red blood cells. Results Group 1: The compression shorts had a positive effect on the disease in 81.3% of patients. Chronic pelvic pain decreased from 6.4 ± 1.6 to 1.2 ± 0.7 points. The coefficient of pelvic congestion syndrome (Cpcs) decreased from 1.73 ± 0.32 to 1.12 ± 0.27 (p < 0.05). In 18.8% of patients, no positive effect was observed. Group 2: The results of radionuclide venographyshowed accelerating outflow of blood from the lower limbs and reduction of insufficiency of perforating veins. Mean radionuclide transit time decreased in all patients in the tendon, muscle pump parts, popliteal vein and was respectively: 23.6 ± 2.2 s, 29.6 ± 3.4 s, 32.3 ± 4.2 s and after treatment 16.4 ± 3.1 s, 22.1 ± 2.5 s, 25.7 ± 1.9 s (p < 0.05). Group 3: The use of compression stockings class II on the clinical manifestations of pelvic congestion syndrome in the patients. Cpcs also remained unchanged. Conclusion Research has shown the efficiency of class II compression shorts in the treatment of patients with isolated extension of intrapelvic venous plexuses. Class II compression stockings do not have any impact on the clinical manifestations of pelvic congestion syndrome.

摘要

目的 研究压迫治疗对盆腔淤血综合征患者盆腔临床表现及静脉血流动力学的影响。材料与方法 对2008 - 2015年74例盆腔淤血综合征患者进行了压迫治疗的不同选择和模式的前瞻性研究。患者分为三组。第一组由48例有盆腔淤血综合征症状和慢性盆腔疼痛的患者组成。他们使用II级压迫短裤。第二组有14例盆腔淤血综合征患者,有外阴静脉曲张但无盆腔疼痛。他们使用II级压迫短裤和长袜。第三组12例有盆腔淤血综合征和慢性盆腔疼痛的女性仅使用II级压迫长袜。治疗持续14天。临床标准是慢性盆腔疼痛严重程度的变化。使用放射性核素静脉造影和体内标记红细胞的发射计算机断层扫描对治疗效果进行评估。结果 第一组:压迫短裤对81.3%的患者疾病有积极影响。慢性盆腔疼痛从(6.4±1.6)分降至(1.2±0.7)分。盆腔淤血综合征系数(Cpcs)从(1.73±0.32)降至(1.12±0.27)(p<0.05)。18.8%的患者未观察到积极效果。第二组:放射性核素静脉造影结果显示下肢血液流出加速且穿通静脉功能不全减轻。所有患者在肌腱、肌肉泵部位、腘静脉的平均放射性核素通过时间分别为:(23.6±2.2)s、(29.6±3.4)s、(32.3±4.2)s,治疗后分别为(16.4±3.1)s、(22.1±2.5)s、(25.7±1.9)s(p<0.05)。第三组:II级压迫长袜对患者盆腔淤血综合征的临床表现无影响。Cpcs也保持不变。结论 研究表明II级压迫短裤对盆腔内静脉丛孤立扩张患者的治疗有效。II级压迫长袜对盆腔淤血综合征的临床表现无任何影响。

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