摘要
目的:探讨改良内翻抽剥法在大隐静脉抽剥过程中隐神经损伤预防中的作用。方法:采用改良内翻抽剥法治疗大隐静脉属支曲张250例(350条肢体),技术要点包括:①选用超长(300 cm)小口径(2.6 mm)抽剥器确保内翻抽剥;②尽可能在切口以远低位切断踝部大隐静脉,保证有足够长度的静脉残端与抽剥器固定;③先剥脱曲张属支再抽剥主干以减少抽剥过程中属支对主干的牵扯。结果:本组全部完成大隐静脉自踝至腹股沟全程内翻抽剥。并发症包括腹股沟血肿1例,术后1周时出现隐神经损伤症状1例。结论:手术技巧改良提高了大隐静脉内翻抽剥技术成功率,可较好地预防隐神经损伤发生。
Objective To explore the role of modified invaginated stripping technology to prevent saphenous nerve injury during great saphenous varicose veins surgery.Methods Modified invaginated stripping technology was performed for 250 patients（350 legs） with primary great saphenous vein（GSV） varicose.Technical steps included：（1） a long stripper（300 cm） with small diameter（2.6 mm） selected to ensure invaginated stripping;（2） cutting off GSV as distal as possible to the ankle incision to achieve reliable fixation of GSV stump with stripper;（3） avulsion of the varicose tributaries performed before GSV stripping so as to diminish the stretch to GSV by these tributaries.Results Invaginated stripping was successfully performed in all the patients.Postoperative complications included groin hematoma occurred in one patient.Saphenous nerve injury was found in one patient on the seventh day after operative.Conclusions Success rate of GSV invaginated stipping increases by technical revisions,which results in low incidence of saphenous nerve injury.
出处
《外科理论与实践》
2012年第2期157-159,共3页
Journal of Surgery Concepts & Practice
关键词
下肢静脉曲张
隐神经损伤
大隐静脉剥脱术
内翻抽剥法
Varix of lower limb
Saphenous nerve injury
Stripping of great saphenous vein
Invaginated stripping
