大隐静脉曲张刨吸术53例报告  

Treatment of varicose greater saphenous vein with transilluminated powered phlebectomy: A report of 53 cases

作　　者：孙镇蛟 金旭文 林森旺[1] 张维萍[1] 陆磊[1] 

机构地区：[1]上海市中西医结合医院微创外科,上海200082

出　　处：《中国微创外科杂志》2006年第6期463-464,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 探讨刨吸术（TriVex,transilluminated powered phlebectomy）治疗大隐静脉曲张的疗效. 方法 2003年3月～2005年6月,我院对53例（74条肢体）大隐静脉曲张行TriVex治疗.所有患肢术前均行Doppler超声证实深静脉通畅,腰麻下高位结扎并抽剥大隐静脉主干,对曲张的分支采用TriVex系统进行刨吸. 结果 53例手术均获成功.单条肢体手术时间24～65 min,（38.1±7.2） min;切口数量3～6个,（4.8±0.8）个,住院时间4～15 d,（9.5±2.2） d.术后患肢出现皮下淤血42条,血肿3条,肢体局部麻木感29条,无深静脉血栓形成.49例（68条肢体） 随访2～24个月,（6.0±4.3）月,皮下淤血及血肿消退,肢体局部麻木感消失20条,减轻9条,患肢小腿部无明显手术瘢痕;原有溃疡愈合,色素沉着减轻,沉重感缓解,无静脉曲张复发. 结论 TriVex治疗下肢静脉曲张具有创伤小、美容效果好的特点,但仍有一定的并发症需要防治.Objective To evaluate the efficacy of transilluminated powered phlebectomy using the TriVex system in the treatment of varicose great saphenous vein. Methods A total of 53 cases （74 legs） of varicose greater saphenous vein were treated by using the Trivex system from March 2003 to June 2005. Preoperative Doppler ultrasonography was utilized to clarify the deep vein of lower limbs was unobstructed. Under lumbar anesthesia, sapheno-femoral-junction ligation, stripping of the long saphenous vein, and phlebectomy of side branches were performed with the Trivex system. Results The operation was performed successfully in all the 53 cases. The operation time per leg was 24 - 65 min （38.1 ± 7.2 min）. The number of incisions for phlebectomy was 3 - 6 （4. 8 ± 0. 8）. The hospital stay was 4 - 15 d （9.5 ±2.2 d）. Postoperative complications included bruising in 42 legs, hematoma in 3 legs, and local paraesthesia in 29 legs. No deep vein thrombosis occurred. Follow-up checkups were carried out in 49 cases （68 legs） for 2 -24 months （6.0 ±4.3 months）. Bruising and hematoma disappeared in all the cases. Local paraesthesia vanished in 20 legs and subsided in 9. No prominent scar was found in the calf region. The pre-existing ulcers healed up, pigmentation decreased in severity, and heavy feeling was relieved. No recurrence of varicosis was noted. Conclusions Treatment of varicose great saphenous vein with the TriVex system has advantages of minimal invasion and satisfactory cosmetic effects, though the incidence of some complications cannot be entirely avoided.

关 键 词：静脉曲张 大隐静脉 刨吸术 

分 类 号：R654.3[医药卫生—外科学]