彩色多普勒超声在腔内钬激光治疗大隐静脉曲张中的应用价值  

Applied Value of Color Doppler Ultrasound on Varicose Great Saphenous Vein after Intracavitary Holmium Laser Treatment

作　　者：赵维群[1] 姜东林[1] 刘小铭[1] 蒋燕东[1] 

机构地区：[1]无锡市第三人民医院超声科,江苏无锡214041

出　　处：《中国医学影像学杂志》2011年第12期921-923,共3页Chinese Journal of Medical Imaging

摘　　要：目的探讨彩色多普勒超声在腔内钬激光治疗大隐静脉曲张中的应用价值。资料与方法术前对76例大隐静脉曲张患者的85条下肢进行超声检查,筛选出适合行腔内钬激光治疗术的大隐静脉曲张54条,术后复查彩超观察疗效。结果 85条患肢,单纯性大隐静脉曲张10条(11.8%),合并下肢深静脉瓣膜功能不全75条(88.2%),其中Ⅰ级18条(21.2%),Ⅱ级26条(30.6%),Ⅲ级20条(23.5%),Ⅳ级11条(12.9%),同时合并下肢深静脉血栓2条(2.4%),血栓再通治疗后1条。术后所有患者曲张静脉消失,患肢沉重酸胀感缓解,色素沉着减轻,溃疡逐渐愈合。术后1周彩超检查,大隐静脉出现不同程度的血栓形成;术后1个月复查彩超,大隐静脉主干均出现血栓性闭塞;术后6个月复查,1名患者出现血管腔再通,再次用激光治愈。结论彩色多普勒超声对大隐静脉及下肢深静脉检查具有无创、可重复和较高的敏感性、特异性,在腔内激光治疗大隐静脉曲张中具有重要的应用价值。Purpose To investigate the value of color Doppler ultrasound on varicose great saphenous vein after intracavitary holmium laser treatment. Materials and Methods Color Doppler ultrasound was utilized to evaluate 85 lower limbs with varicose great saphenous veins in 76 patients, and 54 lower limbs were selected to be treated with intracavitary holmium laser. Ultrasound measurements were performed after operation. Result Among all 85 lower limbs, 10 were simple great saphenous varicose, while 75 had defective lower limb deep-vein valves, including Level 1 in 18 cases （21.2%）, Level Ⅱ in 26 cases （30.6%）, LevelⅢ in 20 cases （23.5%） and level IV in 11 cases （12.9%）. Two cases were complicated with deep vein thrombosis. There was 1 post-treatment recanalized thrombus. After operation, the varicose veins disappeared in all cases. The color ultrasound examination showed thrombi forming in the great saphenous veins to various degrees in I week after surgery. Thrombotic obstruction occurred 1 month after surgery. Revascularization was identified in 1 case and the patient had undergone second laser treatment. Conclusion The color Doppler ultrasound has the advantage of noninvasiveness, repeatability, comparative sensitivity and specificity when evaluating great saphenous vein and deep vein of lower limb. It is useful in intracavitary holmium laser treatment of varicose great saphenous vein.

关 键 词：静脉曲张 隐静脉 激光手术 超声检查 多普勒 彩色 

分 类 号：R543.6[医药卫生—心血管疾病]