破子综合征的当代管理:一个系统的审查
Sabit Sarikaya1, Ozge Altas1, Mustafa Mert Ozgur1
1Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
Annals of vascular surgery
|August 15, 2025
概括
破子综合征 (NCS) 的治疗方法各不相同,手术转移和支架显示出高症状分辨率. 个性化的患者资料是选择这种罕见的血管疾病的最佳管理策略的关键.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 破子综合征 (NCS) 是一种罕见的血管疾病,涉及左静脉 (LRV) 压缩.
- 管理选择范围从保守的方法到开放的,腹腔镜,机器人和内血管干预.
- 由于NCS的稀有性和可变的结果,选择最佳治疗是具有挑战性的.
研究的目的:
- 系统地评估当前对破子综合征 (NCS) 的治疗策略.
- 为了比较各种NCS干预措施的有效性和重新干预率.
主要方法:
- 对NCS治疗研究的系统审查,包括保守的管理,LRV/LGV转移,脏自移植 (RAT) 和支架.
- 在PubMed/MEDLINE,Cochrane图书馆和科学网 (2014年8月至2025年1月) 进行文献搜索.
- 数据收集遵循PRISMA指导方针,评估症状缓解,疼痛/血改善以及重新干预的需要.
主要成果:
- 分析了与578名患者的24项研究;干预措施包括内血管支架 (76%的分辨率),RAT (69%),外血管支架 (80%),LRV转移 (92%),LGV转移 (61%) 和保守管理 (52%).
- 血管外支架显著增加了大气管中枢角 (AMA) 从20.6°增加到44.5° (P < 0.001).
- 在LRV转移中,再干预率最高 (28.5%),而外血管支架,LGV转移和混合程序报告没有再干预.
结论:
- 在传统的LRV转换之外,NCS存在广泛的治疗选择.
- 根据患者解剖学和临床形状的个性化治疗选择至关重要.
- 数据有限,随访时间短,报告不一致,阻碍了标准化治疗算法开发.
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