超声引导下泡沫硬化剂闭合交通静脉对下肢静脉性溃疡的治疗效果  

The treatment effect of venous leg ulcer by ultrasound-guided foam sclerotherapy for perforating veins closure

作　　者：刘洪[1] 张矛[1] 叶小萍[2] 王婧[2] 赵渝[1] 

机构地区：[1]重庆医科大学附属第一医院血管外科,重庆400016 [2]重庆医科大学附属第一医院超声科,重庆400016

出　　处：《中国血管外科杂志（电子版）》2016年第2期136-138,共3页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：重庆市卫计委2014医学科研重点项目(20141002)

摘　　要：目的探讨超声引导下泡沫硬化剂闭合小腿交通静脉对治疗下肢静脉性溃疡的临床效果。方法选择2014年12月至2016年1月期间在本院接受超声引导下泡沫硬化剂闭合浅静脉及小腿交通静脉的静脉性溃疡患者(C6期),通过彩色多普勒超声对静脉闭合情况进行随访并观察术后皮肤溃疡的愈合情况。结果92例患者共95条患肢接受治疗,经超声证实均存在1~3支交通支病变。平均闭合小腿交通静脉2.2条(1~3条),每条肢体平均使用泡沫硬化剂12 ml(聚多卡醇∶空气=1∶4)。2例术后出现一过性胸闷,7例出现小腿局部浅静脉炎表现,未出现下肢深静脉血栓形成以及心脑血管缺血等严重并发症。术后平均随访7.7(1~14)个月,发现交通支均已闭合,皮肤溃疡愈合。结论超声引导下泡沫硬化剂闭合小腿交通静脉是一种安全有效的治疗方法,可有效减少下肢静脉性溃疡的复发。Objective To evaluate the clinical effects of perforating vein closure by ultrasound-guided foam sclerotherapy for the treatment of venous leg ulcer.Methods Selected patients with venous ulcers(CEAP level,C6) that underwent superficial and perforating veins closure by ultrasound-guided foam sclerotherapy in our hospital during December 2014 to January 2016.All patients were followed up by color Doppler scanning for veins closure,and the postoperative healing of skin ulcers were observed at the same time.Results A total of 92 patients with 95 limbs were enrolled,which were confirmed 1~3 perforating vein lesions by ultrasound.An average of 2.2 perforators were closed per leg(1~3 perforators),the average volume of foam sclerosing agent was 12 ml per leg(polidocanol:air =1 ∶4).Two cases had transient chest tightness,and 7 cases had local superficial phlebitis.No serious complications like lower extremity deep vein thrombosis or cardio-cerebrovascular ischemia occurred.During the average follow-up period of 7.7(1 ~14) months,the perforating veins were closed and skin ulcers healed.Conclusion Closure of perforating vein by ultrasound-guided foam sclerotherapy is a safe and effective treatment,can effectively reduce the recurrence of venous ulcer of lower extremities.

关 键 词：多普勒超声 泡沫硬化疗法 慢性静脉功能不全 静脉性溃疡 交通静脉 

分 类 号：R654.4[医药卫生—外科学] R445.1[医药卫生—临床医学]