术中经大隐静脉行下肢深静脉逆行造影的临床应用  

The Clinical Application Value of Descending Venography of Lower Extremity'S Deep Vein with Great Saphenous During Operation

作　　者：蔡海[1] 李中华[1] 陆皓[1] 钱燚[1] 史建能 周苏君[1] 

机构地区：[1]江苏大学附属宜兴医院,江苏宜兴214200

出　　处：《中国医学创新》2014年第33期148-150,共3页Medical Innovation of China

基　　金：江苏大学医学临床科技发展基金资助项目(JLY20120068)

摘　　要：目的:探讨术中经大隐静脉行下肢深静脉逆行造影的临床应用价值。方法:术中自大隐静脉主干置放造影导管,先行髂静脉顺行造影,后短时阻断股静脉,缓慢推注碘佛醇造影剂,透视下观察深静脉瓣膜开放及造影剂逆流程度,深静脉瓣膜功能判定参照Kistner分级标准。结果:本组171例患者中,Kistner逆流分级:0级35例(20.5%),Ⅰ级33例(19.3%),Ⅱ级59例(34.5%),Ⅲ级30例(17.5%),Ⅳ级14例(8.2%)。临床分级:轻度38例,中度82例,重度51例。合并股总静脉狭窄2例,髂静脉受压综合征7例。结论:术中逆行造影能更客观显示深静脉瓣膜功能,造影显示的逆流程度与静脉曲张病变的轻重程度不呈正比。Objective：To investigate the clinical application value of descending venography of lower extremity＇s deep vein with great saphenous during operation.Method：The descending venography was performed during the lower extremity varicose vein surgery, angiographic catheter was placed through great saphenous vein, iliac vein and femoral vein anterograde venography was performed firstly, then the femoral vein was blocked shortly and ioversol contrast medium was injected slowly, the openness and reflux of deep venous was observed under fluoroscopy. The Kistner classification standard was used to determine the function of deep venous.Result：All of the 171 cases were successfully observed. There were 35 cases of grade 0（20.5%）, 33 cases of grade Ⅰ（19.3%）, 59 cases of grade Ⅱ（34.5%）, 30 cases of grade Ⅲ（17.5%）and 14 cases of grade Ⅳ（8.2%）. Clinical classification： 38 cases were mild, 82 cases of moderate and 51 cases were severe. 2 cases of femoral vein stenosis and 7 cases of iliac vein compression syndrome were diagnosed.Conclusion：Descending venography of lower extremity deep vein during operation can objectively shows the function and reflux of deep venous. There is no positive correlation between the degree of reflux imaging showed and lesion of clinical pathological changes.

关 键 词：下肢深静脉逆行造影 大隐静脉 股静脉 

分 类 号：R543.6[医药卫生—心血管疾病]