下肢浅静脉曲张合并血栓性浅静脉炎的治疗体会  

Clinical experience in the treatment of venous varicosis complicated with thrombophlebitis of the lower limb

作　　者：唐军建[1] 郭劲松[1] 倪良宏[1] 王长春[1] 

机构地区：[1]淮北矿工总医院血管外科,安徽淮北235000

出　　处：《外科理论与实践》2008年第5期450-452,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:总结下肢浅静脉曲张合并血栓性浅静脉炎的治疗细节与预后的关系。方法:对127例下肢浅静脉曲张合并血栓性浅静脉炎病人行下肢深静脉造影和临床-病因-解剖-病理(CEAP)分级,然后分别给予药物治疗和大隐静脉高位结扎加浅静脉剥脱术,先期处理Cockett综合征或同时处理股静脉瓣功能不全。结果:43例71条下肢(43/127,71/170)治疗效果良好,术后并发症包括切口淋巴漏4例4条(4/170),继发下肢急性深静脉血栓形成8例9条(9/170),出现下肢水肿5例7条(7/170),皮下血肿和硬结51例63条(63/170),隐神经损伤足靴区麻木10例10条(10/170),血栓性浅静脉炎复发6例6条(6/170)。结论:下肢浅静脉曲张合并血栓性浅静脉炎应全面评估和综合处理,并关注围手术期的治疗细节,防止下肢深静脉血栓形成等并发症的出现。Objective To study the correlation between the therapeutic strategies and the prognosis of clinical results of venous varicosis complicated with superficial thrombophlebitis of the lower limb（s）. Methods A total of 127 cases with venous vaficosis complicated with superficial thrombophlebitis were submitted to deep venography and clinicaletiological-anatomlcal- pathophysiological （CEAP） classification, followed by pharmacotherapy and high ligation of great saphenous vein, combined with stripping of the superficial veins of the lower limb（s）. External valvuloplasty of the femoral vein valve was performed in cases of deep venous valve insufficiency simultaneously, and the patients with Cockett syndrome were treated preoperatively. Results Forty-three cases （71 legs） acquired relatively good therapeutic results. Postoperative complications included lymphatic leakage in 4 cases, deep vein thrombosis in 8 cases, edema in 5 cases, ecchymoma and sclerosis in 51cases, medial malleolus anaesthesia caused by saphenous nerve injury in 10 cases, recurrence of superficial thrombophlebitis in 6 cases. Conclusions General assessment and comprehensive management should be given to the patients with venous varicosis complicated with superficial thrombophlebitis of the lower limb（s）; and the perioperative therapeutic details should be underscored.

关 键 词：血栓性静脉炎 静脉曲张 血管外科手术 药物疗法 

分 类 号：R654.3[医药卫生—外科学]