小切口瓣膜修复联合血管内激光光凝治疗原发性下肢深静脉瓣膜功能不全十年回顾性临床研究  

Integrative Minitraumatic Valve Reparation with Endovascular Laser Coagulation in Patients with Primary Deep Venous Insufficiency:a 10 year Retrospective Clinical Research

作　　者：王春喜[1] 顾瑛[2] 曾晶[2] 韩丽娜[3] 赵文光[3] 王晓玲[4] 牛磊[1] 

机构地区：[1]解放军总医院普通外科 [2]解放军总医院激光医学科 [3]吉林大学第一医院血管外科 [4]北京市长峰医院普通外科

出　　处：《中国激光医学杂志》2011年第4期213-216,共4页Chinese Journal of Laser Medicine & Surgery

基　　金：军队十五指令计划基金资助(01L020)

摘　　要：目的总结小切口瓣膜修复联合血管内激光光凝治疗原发性下肢深静脉瓣膜功能不全的方法、效果、远期疗效和临床经验。方法原发性下肢深静脉瓣膜功能不全患者1 146例1278条肢体,硬膜外麻醉下取股部小切口,行第一对股浅静脉瓣膜外修复;以波长810 nm的半导体激光对迂曲扩张的大隐静脉进行血管内光凝术。手术后每年进行随访观察,利用超声多普勒确认治疗后的浅静脉是否闭合、深静脉是否反流。结果术后当天患者既可下床,无淋巴漏、深静脉血栓、切口感染等并发症。术后随访6个月和1、2、3、4、5、6、7、8、9、10年的临床治愈率分别为97.96%、97.95%、96.01%、95.60%、95.55%、95.37%、95.01%、94.43%、93.39%、89.02%、88.42%。结论小切口瓣膜修复结联合血管内激光光凝技术,是治疗原发性下肢深静脉瓣膜功能不全,创伤小、恢复快、远期效果好,疗效稳定可靠,值得进一步推广应用。Objective To summarize the experience of an integrative minitraumatic valve reparation with endovascular laser coagulation in patients with primary deep venous insufficiency,and to investigate its methodology,effects,long-term results. Methods The first pair of superficial femoral venous valve was repaired with minimal incision and the varicose veins were coagulated with endovascular laser under epidural anesthesia.The 1 146 cases were followed with Doppler ultrasound from 2000 to 2011 years,and the cure rates and adverse effects were observed each year. Results All patients were cured when discharged from hospital,and their cure results were followed.The post-operative cure rates from six months and 1 to 10 years were 97.96%,97.95%,96.01%,95.60%,95.55%,95.37%,95.01%,94.43%,93.39%,89.02% and 88.42%,respectively. Conclusions The integration of laser photocoagulation with valve repair operations is one kind of convenient,minitraumatic,aesthetic and quick restorative therapeutic method to treat patients with primary deep venous valve insufficiency,and has a good long-term effect.It is deserved to be used widely in the future.

关 键 词：激光光凝 瓣膜修复 深静脉瓣膜功能不全 

分 类 号：R654.3[医药卫生—外科学]