术中超声辅助股浅静脉瓣膜戴戒术治疗下肢深静脉瓣膜功能不全  

Study of encircling constriction of superficial femoral vein in the treatment of primary deep venous insufficiency with the help of Color Doppler

作　　者：凌瑞[1] 王廷[1] 韩增辉[2] 易军[1] 王岭[1] 允军[1] 李晓军[1] 边杰芳[1] 袁时芳[1] 

机构地区：[1]第四军医大学西京医院普三科,陕西西安710032 [2]第四军医大学西京医院超声诊断科,陕西西安710032

出　　处：《中国实用外科杂志》2007年第9期733-735,共3页Chinese Journal of Practical Surgery

摘　　要：目的研究术中加用多普勒超声辅助股浅静脉瓣膜戴戒术治疗原发性下肢深静脉瓣膜功能不全(PDVI)的疗效和应用价值。方法对2001年6月起至2006年6月第四军医大学西京医院经静脉顺行造影证实为PDVI的87例临床资料进行分析。分为两组:A组(44例)行术中联合多普勒超声的股浅静脉瓣膜戴戒术加曲张静脉剥脱术。B组采用传统股浅静脉瓣膜戴戒术加曲张静脉剥脱术。以瓣膜返流持续时间评价即时效果,以癌胚抗原蛋白(CEAP)临床分类与临床记分做随访评价疗效。结果A组病人戴戒前后术中超声检测显示静脉瓣返流持续时间戴戒后较戴戒前明显缩短(P<0.01)。CEAP分组结果显示A组手术有效率达95.0%(38/40),B组有效率为76.7%(33/43),两组有效率比较差异有显著性意义(P<0.01)。A、B两组术后临床记分均明显下降,差异有显著性意义(P<0.01)。结论股浅静脉瓣膜戴戒术采用术中多普勒超声检查进行辅助能够有效提高手术的针对性,提高疗效。Objective To study the effect of Color Doppler in encircling constriction of superficial femoral vein in the treatment of primary deep venous insufficiency （PDVI）. Methods Eighty-seven limbs in 87 patients who were proved to be PDVI by ascending venography were divided into Group A （44 limbs） and Group B （43 limbs）. All the patients were treated with the encircling constriction of venous wall at the first valve of superficial femoral veins and the high ligation and ablation of great saphenous vein, ablation of superficial veins and ligation of perforator veins. But during the operations of patients in Group A, we used Color Doppler to help us. We used lasting time of reflux flow of vein to evaluate the short time effect. CEAP classification and clinical scoring were proceeded from two months to six years after operation to evaluate the long time effect. Results In patients in Group A the lasting time of reflux flow was markedly shortened. The results of CEAP indicated that obviously effective rate of Group A was 95.00 % （38/40） while it was 76. 74% （33/43） in Group B. The difference between two groups＇ effective rate was significant （ P 〈 0.01 ）. The difference between preoperative and postoperative clinical scores of Group A and Group B were both remarkable, between Group A and Group B were also prominent （ P 〈 0. 01 ） Conclusion Appling of Color Doppler is useful to promote the effective rate in the operation encircling constriction of superficial femoral vein in the treatment of PDVI.

关 键 词：原发性深静脉瓣膜功能不全 环形缩窄术 戴戒术 多普勒超声 

分 类 号：R6[医药卫生—外科学]