摘要
一位85歲女性，因失智症長期臥床，自一年前左下肢開始腫脹，九個月前入院檢查，當時經下肢超音波檢查後診斷為左深股靜脈部分栓塞，因此使用低分子量肝素治療一周後，改為新型抗凝血劑Rivaroxaban治療，改善後出院於門診追蹤，但左下肢腫脹惡化，並開始抱怨疼痛，於是再度入院檢查，下肢超音波仍發現左深股靜脈部分栓塞，因伴隨紅腫熱痛，且之前有開過左轉子間骨折／股骨骨折手術，安排發炎掃描，疑似慢性骨髓炎，因此除使用抗凝血劑，抗生素亦使用，但兩周後狀況幾乎沒有改善，因此安排顯影劑電腦斷層檢查，發現左髂靜脈血栓，因此照會心臟血管外科，執行左髂靜脈支架置入術，及導管溶栓術，術後症狀明顯改善。老人下肢水腫是臨床上非常常見的主訴，深層靜脈栓塞(deep vein thrombosis, DVT)在老人有著較高的盛行率，且可能危及生命，老人症狀較不典型，因此需更加謹慎鑑別診斷，其中，髂股靜脈血栓(iliofemoral deep vein thrombosis, IFDVT)相較遠端肢體靜脈栓塞有更高的併發症與死亡率，如何診斷及治療是非常重要的，適當的處置不但能減低局部不適，也能改善生活品質。
並列摘要
An 86-year-old female suffering from progressive left lower limb swelling for 9 months was diagnosed with partial left femoral vein thrombosis and had received Rivaroxaben treatment for approximately 9 months. However, the condition deteriorated, and she was admitted again. Doppler scan was arranged and revealed recurrent partial left femoral vein thrombosis. We prescribed her enoxaparin subcutaneous injection for a 10-day treatment course. Antibiotic was also administrated for the impression of chronic osteomyelitis due to previous operation of her left femur and hip. As no improvement was observed, computed tomography scan was performed, and the result indicated left iliac vein thrombosis. She then received metal stent placement over her left iliac vein, together with catheter-directed thrombolysis, and her left lower limb swelling improved dramatically. The incidence of and morbidity attributable to deep vein thrombosis remain high in the elderly. Among deep vein thrombosis, iliofemoral deep vein thrombosis has higher complication and mortality rates. Iliofemoral deep vein thrombosis is so critical a condition for elderly patients that the importance of knowing how to reach a correct diagnosis and when to initiate proper treatment can never be overestimated.