深静脉瓣膜重建术治疗下肢静脉倒流性疾病  

TREATMENT OF VENOUS REFLUX DISEASE OF THE LEG BY DEEPVENOUS VALVE RECONSTRUCTION

作　　者：戈小虎[1] 王自立[1] 伊玛木 

机构地区：[1]新疆自治区人民医院普外二科

出　　处：《中国修复重建外科杂志》1998年第1期11-13,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：为综合评价切开瓣膜修复术、静脉瓣戴戒术和静脉外肌袢成形术三种深静脉瓣膜重建手术的适应证与疗效，对１９９２年１月～１９９６年６月收治的６２例下肢静脉倒流性疾病患者进行了临床研究。全部患者均有不同程度的浅静脉曲张及下肢酸胀感，其中肿胀３０例，足靴区色素沉着２８例，溃疡１４例。病程为１年～３０年，平均１４．６年。１４例患者采用股浅静脉第１对瓣膜戴戒术，１例患者采用股浅静脉切开瓣膜修复术，４７例患者采用月国静脉外肌袢成形术。术后平均随访２０个月，所有患者症状缓解，１４例溃疡均愈合，无一例复发。结果表明：①戴戒术和瓣膜修补术适用于深静脉瓣膜功能不全倒流Ⅰ级～Ⅱ级；②肌袢成形术适用于深静脉瓣膜功能不全倒流Ⅲ级～Ⅳ级或先天性瓣膜功能缺陷；③戴戒材料宽度应增加到２ｃｍ；④对双股静脉畸形的原发性深静脉瓣膜功能不全，应同时行双股浅静脉第１对瓣膜戴戒术。认为，对月国静脉分支较多者仍可施行月国静脉外肌袢成形术，只要术中仔细操作。In order to evaluate the effect and indication of three kinds of deepvenous valve recoustruction surgery, 62 cases with venous reflux disease of the leg had been treated from Jan. 1992 to Jun. 1996. All the patients had varicose vein and tingle in varying degrees, besides swelling in 30 cases, pigmentation in 28 cases, ulcer in 14 cases. The course of disease ranged from 1 to 30 years (averaged 14.6 years). Method: 14 cases were treated by ringing of the superficial femoral venous 1st valve, 1 case was treated by repairing of the superficial femoral venous 1st valve, 47 cases were treated by formation of substitute valve outside the popliteal vein. The symptoms of all the patients were alleviated with an average followup for 20 months. Fourteem cases with ulcer were healed compeletely and no recur. The conclusion were: ①ringing and repairing of the venous valve were suitable for level Ⅰ～Ⅱ venous valvular incompetence. ②formation of substitute valve outside the popliteal vein was suitable for level Ⅲ～Ⅳ venous valvular incompetence or congenital valvular defect. ③the width of the ringing material should be increased to 2 cm according to the pathological basis. ④both femoral veins should be ringed in the treatment of primary valvular incompetence of double deep vein deformity. ⑤the formation of substitute valve outside the popliteal vein was also available in the treatment of popliteal vein with many branches.

关 键 词：下肢静脉倒流 深静脉瓣膜重建 肌袢成形术 

分 类 号：R654.405[医药卫生—外科学]