目的探讨毒品注射所致感染性假性动脉瘤的特点及治疗方法与临床疗效。方法回顾性分析我院血管外科2009年1月至2010年6月期间收治的13例感染性假性动脉瘤吸毒患者的临床资料，采用切除瘤体及周围炎性组织、瘤腔清创及动脉结扎或人工血管置换术，观察移植效果及并发症发生情况。结果13例手术均获成功，无一例发生肢体坏死； 伤口一期愈合5例，二期愈合8例； 7例发生程度不等的淋巴瘘。随访2～12个月（平均7个月），其中1例术后2个月瘤腔下端感染形成脓肿伴出血，行切开引流痊愈； 2例术后4个月人造血管感染行人造血管摘除，切口换药痊愈； 有2例左肘部假性肱动脉瘤直接行血管结扎，未用人工血管移植； 余8例复查B超显示移植血管通畅，无血栓形成。结论彻底清创、血管移植、控制感染是治疗感染性假性动脉瘤的有效方法。
ObjectiveTo investigate the clinical efficacy of catheter directed thrombolysis (CDT) through three different approaches combined with iliac venous endovascular therapy for acute deep venous thrombosis (DVT) complicated with Cockett syndrome of the lower extremities. MethodThe clinical data of 87 patients with CDT through three different approaches (small saphenous vein group, popliteal vein group, and posterior tibial vein group) combined with iliac venous endovascular therapy for DVT complicated with Cockett syndrome of the lower extremities were analyzed retrospectively. ResultsThe lower extremity swelling of all the patients were disappeared obviously within 72 h after surgery, there was no death related surgery and pulmonary embolism. The limb edema reduction rates had no significant differences among the small saphenous vein group, popliteal vein group, and posterior tibial vein group﹝(77±13)% versus (82±12)% versus (77±18)%, P > 0.05﹞. The recanalization rates of thrombolysis had no significant differences among the above three groups﹝(86.5±10.6)% versus (92.0±7.7)% versus (87.3±7.8)%, P > 0.05﹞. The time required for the cannulation in the posterior tibial vein group was significantly shorter than that of the small saphenous vein group or popliteal vein group﹝(15.14±3.62) min versus (32.62±9.36) min or (42.79±13.30) min, P < 0.01﹞. All the patients were performed by balloon dilatation and iliac vein stenting. Eighty-seven cases were followed-up for 1-24 months, the primary patency rate of iliac venous was 100%. ConclusionsCDT with iliac venous endovascular therapy is an effective method in treatment of acute DVT with Cockett syndrome. CDT through posterior tibial vein is an easier and effective method with less complications and time. This way could be acceptable in basal hospital.