下肢深静脉瓣膜重建术的疗效分析  

Analysis of curative effect of reconstruction of venous valve of lower limbs.

作　　者：王深明[1] 胡作军[1] 黄雪玲[1] 李晓曦[1] 常光其[1] 

机构地区：[1]中山医科大学附属第一医院血管外科,广州510080

出　　处：《中国实用外科杂志》2001年第5期273-275,共3页Chinese Journal of Practical Surgery

摘　　要：目的　分析下肢深静脉瓣膜修复成形术治疗下肢深静脉瓣膜功能不全的临床疗效。方法　对下肢原发性深静脉瓣膜功能不全的 10 1例 116条肢体实施股静脉瓣膜外修复成形术 ,并利用静脉功能不全评分、双向彩超、流速剖面图彩超技术和空气体积描记仪 (APG)等方法对其疗效进行分析。结果　随访率 87 9% ,随访病例症状消失 ,96 1%的肢体浅静脉曲张消失无复发。 13例溃疡肢体中有 11条在术后 36个月溃疡消失 ,2条明显缩小。术前Ⅲ度返流肢体术后 90 %以上静脉瓣膜功能达Ⅱ度以下 ,6 7 6 %的瓣膜功能恢复正常或接近正常 ;静脉功能不全评分从术前 15 33± 1 83改善到术后 5 0 7± 0 6 0 (P <0 0 1) ;术前Ⅳ度返流肢体术后 80 %以上静脉瓣膜功能达Ⅱ度以下 ,40 5 %的瓣膜功能恢复正常或接近正常 ,静脉功能不全评分从术前 17 38± 2 6 7改善到术后7 2 5± 1 12 (P <0 0 1)。 5 1例 5 8条肢体经流速剖面图彩超检查示 ,术后静脉返流量均值比术前明显减少 (P <0 0 1) ;经APG检测术后VFI均值比术前明显减少 (P <0 0 1)。结论　下肢深静脉瓣膜外修复成形术能有效地治疗深静脉瓣膜功能不全 ,并可大大改善血流动力学指标 ,对静脉性溃疡也有一定的疗效。Objective To analyze the clinical effect of external valvuloplasty of femoral vein for deep vein valve insufficiency in the lower limbs.Methods External valvuloplasty of deep vein was performed on 101 patients(116 limbs) with primary deep vein valve insufficiency and the therapeutic effects were analysed by scoring of venous dysfunction,color duplex,color doppler velocity profile technology and APG.Results Follow-up rate was 87 9%.Symptoms of all follow-uped limbs released and varicose veins were gone in the limbs of 96 1%.Of 13 limbs with ulcers,11 limbs presented ulcer healing in 3 to 6 months after operation and 2 limbs presented ulcer decreasing.The valve imcompetence was improved Ⅱ° or below in the limbs of above 90% with Ⅲ° reflux and above 80% with Ⅳ°reflux,while valve competence was found in the limbs of 67 6% with Ⅲ° reflux and 40 5% with Ⅳ° reflux.The scoring venous dysfunction was improved from preoperative 15 33±11 83 to 5 07±0 60(P<0 01) in the limbs with Ⅲ° reflux and from 17 38±2 67 to 7 25±1 12(P<0 01) in the limbs with Ⅳ° reflux.The venous reflux volume was obviously decreased in 51 cases(58 limbs) after operation by color doppler velocity profile technology(P<0 01) and VFI was also greatly decreased postoperatively in these cases by APG(P<0 01).Conclusion External valvuloplasty of deep vein valve was effective to treat deep vein valve insufficiency in the lower limbs.It might greatly improve hemodynamic index and had certain effect in the therapy of venous ulcers.

关 键 词：下肢深静脉瓣功能不全 瓣膜重建术 疗效 APG 

分 类 号：R654.3[医药卫生—外科学]