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原发性下肢深静脉瓣膜功能不全的外科治疗 被引量:2

Surgical Treatment of Primary Deep Venous Valvular incompetence of Lower Limb
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摘要 目的评价股浅静脉瓣膜“戴戒”加曲张浅静脉剥脱术治疗原发性下肢深静脉瓣膜功能不全的临床效果。方法回顾性分析我院血管外科1997~2004年收治的78例(92条)原发性下肢深静脉瓣膜功能不全患者实施股浅静脉瓣膜“戴戒”加曲张浅静脉剥脱术的临床疗效。结果65例(76条)术后症状消失或显著改善,恢复满意;8例(10条)术后症状减轻;3例(4条)术后无改善;2例(2条)术后肿胀加剧,经彩超证实为急性髂股静脉血栓形成。患肢治疗临床总有效率为93.5%(86/92),手术并发症发生率为2.2%(2/92)。结论原发性下肢深静脉瓣膜功能不全的外科治疗应严格掌握手术指征,股浅静脉瓣膜“戴戒”加曲张浅静脉剥脱术对重度瓣膜功能不全患者疗效确切、操作简便,是外科治疗的有效术式。 Objective To evaluate the surgical effects of indirect loop valvuloplasty of the superficial femoral vein plus superficial varicose veins stripping on primary deep venous valvular incompetence of the lower limb. Methotis Seventy-eight patients (92 limbs) with primary deep venous valvular incompetence of the lower limbs received the operations of indirect loop valvuloplasty of the superficial femoral vein plus superficial varicose veins from 1997 to 2004. There were 65 males and 13 females, and their ages ranged from 32 years to 72 years (mean age of 52.5 years). The valvular reflux grades of these 92 limbs varied from Ⅲ to Ⅳ according to Kistner's standard. A sleeve made from the stripped great saphenous vein was used in the indirect loop valvuloplasty of the superficial femoral vein. The early results of surgery were retrospectively analyzed. Results Pre-operative symptoms, such as edema, ulceration, pigmentation and heavy feeling of the performed limbs disappeared or were remarkably improved in 65 cases (76 limbs) after operation. Eight cases (10 limbs) had alleviative symptoms compared with pre-operative ones. Meanwhile, no improvement of symptoms was observed in 3 patients (4 limbs). Acute ilio-femoral vein thrombosis occurred in 2 patients (2 limbs), which manifested as more servious edema of the lower limbs than those before operation. The overall effective rate of surgery was 93.5% (86/92), and the complications rate was 2. 2% (2/92). Conclusion Indirect loop valvuloplasty of the superficial femoral vein plus superficial varicose vein stripping is an effective and convenient way to correct the primary deep venous valvular incompetence of the lower limb. The surgical indications of this disease should be emphasized strictly to assure the good outcomes.
出处 《中国普外基础与临床杂志》 CAS 2006年第6期659-661,共3页 Chinese Journal of Bases and Clinics In General Surgery
关键词 深静脉 瓣膜功能不全 瓣膜成形术 Deep vein Valvular incompetence Valvuloplasty
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