下肢静脉曲张的微创治疗  

Micro-invasive Surgery in Treatment of Varicose Vein in Lower Limbs

作　　者：林少芒[1] 林细吟[2] 张智辉[1] 温子龙[1] 姚燕丹[1] 黄仲初[1] 

机构地区：[1]广州医学院第二附属医院血管外科,广东广州510260 [2]中山大学护理学院

出　　处：《中国医师杂志》2005年第10期1338-1339,共2页Journal of Chinese Physician

摘　　要：目的探讨Trivex微创刨吸术治疗下肢静脉曲张适应证、手术技巧和疗效。方法应用Trivex微创刨吸术对106条患下肢静脉曲张的肢体进行治疗,其中同时合并血栓性浅静脉炎16条,合并足部皮肤色素沉着和慢性溃疡38条。对小腿交通支静脉功能不全者加做交通支静脉结扎术(SEPS),出现深静脉瓣膜功能不全加做血管镜下瓣膜修补术。分析Trivex微创刨吸术的手术技巧、治疗效果、适应症和并发症。结果对106条下肢静脉曲张的患肢应用Trivex微创刨吸术均获得满意的疗效。无出现伤口和肢体软组织感染,12条患肢(11.2%)出现不同程度血肿;术后皮肤瘀斑3周后全部消失;38条患肢慢性溃疡术后全部愈合;足踝部皮肤色素沉着逐步消退。并发症主要是血肿,皮下淤瘢和手术区不同程度麻木感,足背区的静脉曲张刨吸应慎重,本组2例足背静脉曲张刨吸术后均出现麻木和部分足趾肌键粘连。结论Trivex微创刨吸术对下肢静脉曲张以及伴血栓性浅表静脉炎或伴下肢慢性溃疡疗效肯定,微创,美观。术后驱除剩余充盈液和积血是防止术后血肿的关键,充盈液中加入适量的抗生素能防止肢体软组织感染。娴熟的手术技巧能有效减少可能发生的并发症,作为新技术远期疗效还需进一步追踪。Objective To investigate the skills and effects of TriVex system and to discuss its indications and complications in the treatment of varicose vein in lower limbs. Methods The TriVex system operation was underwent in 106 lower limbs with varicose vein. Sixteen of them showed thrombophlebitis while 38 of them showed chronic ulcer and pigmentation. The lower limbs with perforating vein were treated with subfaseial endoscopic perforator vein surgery （SEPS） and limbs with deep insufficient vein valve underwent endoscopic valve repair. Results The therapeutic effect of TriVex system was satisfactory and none of them had soft tissue infection. Hematoma occurred in 12 lower limbs（11.2%）. Pigmentation and skin peteehia disappeared in 3 weeks after operation. Chronic ulcer healed and ankle pigment reduced in 38 limbs. Hematoma, peteehia and numbness were the common complications in the patients with varicose vein in lower limbs. Conclusion It was effective, cosmetic and micro invasive to use the TriVex system in the treatment of thrombophlebitis and varicose vein with chronic ulcer. Adept operation skill can minimize the postoperative complications but the long-term effects of this new technique still needed follow-up studies.

关 键 词：静脉曲张 微创 疗效 下肢静脉曲张 微创治疗 深静脉瓣膜功能不全 下肢慢性溃疡 微创刨吸术 血栓性浅表静脉炎 皮肤色素沉着 

分 类 号：R654.4[医药卫生—外科学]