彩超辅助下股浅静脉瓣膜环包术治疗原发性下肢深静脉瓣膜功能不全67例体会  

Color ultrasonography guided polytef strip wrapping of the first pair of valve of the superficial femoral vein for the treatment of primary deep vein valvular insufficiency of the lower limb

作　　者：俞景奎[1] 李燕[1] 

机构地区：[1]山东省滕州市中心人民医院外科,277500

出　　处：《中华普通外科杂志》2007年第8期597-600,共4页Chinese Journal of General Surgery

摘　　要：目的评价术中彩超辅助下股浅静脉瓣膜环包术治疗原发性下肢深静脉瓣膜功能不全的疗效。方法回顾性分析1998年1月至2005年12月收治的原发性下肢深静脉瓣膜功能不全67例（76条患肢）的临床资料，根据不同时间段将患者分为两组，非彩超辅助组（1998年1月至2000年12月）33例（38条患肢），在股浅静脉和股深静脉汇合处稍远侧找到股浅静脉的第1对瓣膜，用人工血管片缩窄该处血管周径约1／3；彩超辅助组（2001年1月至2005年12月）34例（38条患肢），彩超确定股浅静脉第1对瓣膜的位置及返流程度，人工血管片均匀环包瓣膜，缩窄该处血管周径约1／4～1／3。结果术后1年两组间比较，彩超检查股浅静脉瓣膜返流时间，彩超辅助组≤1S的患肢明显增加，1～6S的患肢明显减少。差异均有统计学意义（P〈0．01；P〈0．05）。X线造影检查股浅静脉瓣膜功能，彩超辅助组患肢0级明显增加；Ⅰ～Ⅲ级明显减少。差异均有统计学意义（P〈0．01；P〈0．05）。结论术中彩超辅助下确定股浅静脉瓣膜的位置、返流程度，从而确定人工血管片环包位置确切、程度恰当。与传统股浅静脉瓣膜环包术比较有明显的优越性。Objective To evaluate the curative effect of PTFE artificial vascular graft strip wrapping of the first pair valves of superficial femoral vein under the guidance of color ultrasonography during operation in the treatment of primary deep vein valvular inadequacy of the lower limb. Methods From Jan 1998 to Dec 2005, 76 limbs （67 cases） were divided into two groups with the surgical procedure not guided by color ultrasonography in 38 limbs （33 cases） in control group and ultrasound guided group （treatment group） in which （38 limbs in 34 cases）the location of the first pair of valvae of superficial femoral vein was found out and the blood regurgitation was measured. Polytef strip was used to constrict the vascular diameter by about 1/3. Artificial vascular flake packed circularly and evenly to constrict the vascular diameter by about 1/4 to 1/3 in group with help of color ultrasonography. Results One year after operation, a comparison between the two groups was performed. Valvular reflux time of superficial femoral vein was determined by color ultrasonography. Compared with control group in the treatment group, the number of sick limb in which the reflux time 〈 1 s significantly increased, while the number, in which the reflux time was within 1 - 6 s, decreased （ P 〈 0. 01 ; P 〈 0. 05 ）. Valvular function of superficial femoral vein determined by radiography showed that the number of 0 grade sick limb in the treatment group increased significantly, while the number of Ⅰ -Ⅲ grade decreased （ P 〈 0. 01 ; P 〈0. 05 ）. Condnsion Color ultrasonography helps to locate the valvular position and reflux degree of superficial femoral vein making the procedure easy and correct.

关 键 词：静脉功能不全 超声检查 多普勒 彩色 人工血管 血管外科手术 

分 类 号：R686[医药卫生—骨科学]