下肢慢性静脉溃疡的综合治疗  

Comprehensive treatment of chronic venous leg ulcers

作　　者：黄楷[1] 梁思华[1] 黄明清[1] 朱晓彤[1] 吴文洁[1] 黎洪浩[1] 

机构地区：[1]中山大学孙逸仙纪念医院 血管外科,广州510120

出　　处：《中国血管外科杂志（电子版）》2013年第3期178-181,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨下肢慢性静脉溃疡的综合治疗方法。方法回顾性分析2012年7月~2013年1月我科收治的10例下肢慢性静脉溃疡患者(10条患肢)的临床资料,均采用大隐静脉高位结扎加抽剥并联合应用透光曲张静脉刨吸术、泡沫硬化剂注射、腔镜深筋膜下交通静脉结扎术等方法处理小腿病灶。分别在术前及术后3个月对临床症状的改善情况采集数据,按临床严重程度评分(VCSS)方法进行评估。结果患者均成功实施联合手术治疗方案,在术后的VCSS评分项目中得到改善[(12.3±2.06)vs(9.6±1.71)]。随访(6.70±1.45)个月,疼痛较前均有缓解,未发现患肢有曲张浅静脉残余或复发,8例溃疡基本愈合,仅有2例还有残余溃疡,但都控制在2 cm内,已愈合的溃疡未见复发。结论下肢慢性静脉溃疡经正确选择联合治疗方案进行处理后的效果是理想且安全的,而且其短期效果稳定。Objective To discuss comprehensive surgery strategy of chronic venous ulcerations (CVU). Methods From July 2012 to January 2013,the clinical date of ten patients (10 limbs) with CVU treated in our hospital were reviewed. All cases received great saphenous vein high ligation and stripping, transilluminated powered phlebectomy (TIPP), subfascial endoscopic perforators surgery (SEPS) and foam sclerotherapy. Venous Clinical Severity Score (VCSS) was assessed preoperation and three months after surgery. Results Comprehensive surgery was performed successfully in all patients. VCSS was improved from preoperation(12.3 ± 2.06)to postoperation(9.6 ± 1.71). After (6.70±1.45) months follow-up, for all cases, pain relieved and no recurrence of varicose superficial veins presented. Moreover, ulceration healing happened in 8 cases, while, residual ulcerations presented in only 2 cases(diameter<2cm). No recurrence presented in healing ulcerations. Conclusion The comprehensive surgery strategy treating CVU is feasible and safe, with favourable short-term outcomes.

关 键 词：下肢慢性静脉溃疡 透光直视旋切术 泡沫硬化剂注射 腔镜深筋膜下交通静脉结扎术 

分 类 号：R654.3[医药卫生—外科学]