目的:比较导管接触性溶栓（CDT）与AngioJet经皮机械血栓切除术（PMT）治疗急性下肢深静脉血栓形成（DVT）合并髂静脉压迫综合征（IVCS）的疗效和安全性。方法:回顾性分析2016年6月至2019年3月广州医科大学附属第二医院血管外科收治的134例急性DVT合并IVCS患者的临床资料，分为CDT联合髂静脉腔内成形术组（CDT组，68例）和PMT（AngioJet）联合髂静脉腔内成形术组（PMT组，66例）。观察两组围术期并发症的发生率，术后深静脉和支架血流通畅情况，Villalta评分以及CIVIQ-2评分。结果:CDT组和PMT组技术成功率均为100%，两组患者均在溶栓前置入下腔静脉滤器。CDT组Ⅲ级血栓清除率为76.5%（52/68），Ⅱ级血栓清除率为23.5%（16/68），支架植入41例（45枚），滤器回收率为88.2%（60/68）。PMT组Ⅲ级血栓清除率为75.8%（50/66），Ⅱ级血栓清除率为24.2%（16/66），支架植入42例（56枚），滤器回收率为86.4%（57/66）。CDT组住院时间[（10.09±3.27）d]较PMT组[（7.94±3.08）d]长，差异有统计学意义（n U=1 306, n P<0.001）；两组术后3 d患肢小腿周径与术前比较的周径差分别为（1.51±1.21）cm和（2.48±1.83）cm，差异有统计学意义（n U=1 502，n P=0.001）。CDT组出血并发症发生率为17.6%（12/68），PMT组3%（2/66），差异有统计学意义（n χ2=7.648，n P=0.006），两组均未发生严重肾功能障碍、致死性肺栓塞、严重颅脑出血。随访时间为（10.57±7.44）个月（范围：1~33个月），CDT组和PMT组术后12个月的静脉通畅率分别为88.9%（16/18）和95.2%（40/42），差异无统计学意义（n P=0.576）；两组Villalta评分和CIVIQ-2评分差异仅在术后1个月有统计学意义（n P=0.011，n P<0.001）。n 结论:急性下肢DVT合并IVCS行AngioJet经皮机械血栓切除术联合同期髂静脉腔内治疗，较CDT联合髂静脉腔内治疗，患肢肿胀消退、疼痛减轻更快，围术期出血并发症发生率更低，住院时间更短。“,”Objective:To compare the curative effect and safety of catheter-directed thrombolysis (CDT) and percutaneous mechanical thrombectomy (PMT) in the treatment of acute lower limb deep venous thrombosis (DVT) with iliac vein compression syndrome (IVCS).Methods:The data of 134 patients with acute DVT and IVCS in Department of Vascular Surgery, the Second Affiliated Hospital of Guangzhou Medical University from June 2016 to March 2019 were collected. Among 134 patients, 68 patients were treated with CDT (CDT group) and 66 with AngioJet PMT (PMT group). The therapeutic effect evaluation, the incidence of perioperative complications, the patency of deep vein and stent, Villalta score and CIVIQ-2 score were compared between two groups.Results:The technical success rate of both group was 100%. The inferior vena cava filters (IVCF) were implanted in all patients before thrombolysis. Between CDT group and PMT group, the thromboclearance rate of grade Ⅲ and grade Ⅱ was 76.5%(52/68), 23.5%(16/68) and 75.8%(50/66), 24.2%(16/66), respectively. And the stents were implanted in 41 cases (45 stens) and 42 cases (56 stents), respectively. The IVCF recovery rate was 88.2% (60/68) and 86.4% (57/66), respectively. The hospitalization days of CDT group were significantly longer than PMT group ([(10.09±3.272) d n vs (7.94±3.08) d, n U=1 306, n P<0.001). The peripheral diameter difference of leg between preoperative and postoperative 3 days was (1.51±1.21) cm in CDT group and (2.48±1.83) cm in PMT group, and the difference was statistically significant (n U=1 502, n P=0.001). The incidence of bleeding complication was 17.6% (12/68) in CDT group and 3% (2/66) in PMT group, and difference was statistically significant (n χ2=7.648, n P=0.006). During the follow-up of (10.57±7.44) months (range:1-33 months), the target vein patency rate at 12-month after operation was 88.9% (16/18) in CDT group and 95.2%(40/42) in PMT group, respectively (n P=0.576). And the Villalta score and CIVIQ-2 score of the two groups were statistically significant only at 1-month afteroperation (n U=1 692, n P=0.011; n U=1 426, n P<0.001) .n Conclusion:AngioJet PMT combined with simultaneous intravenous iliac vein therapy for acute lower extremity DVT complicated with IVCS is more effective than CDT combined with intravenous iliac vein therapy,with faster relief of swelling and pain of affected limbs, lower incidence of bleeding complications during perioperative period and shorter hospitalization days.