诊治下肢交通静脉瓣膜功能不全的新技术及其临床应用  

New technology of diagnosis and treatment on incompetent perforator veins

作　　者：刘咸罗[1] 钱小星[1] 汤永胜[1] 马芳[1] 吴茂松[1] 陈克辉[1] 柳小刚[1] 胡钢[1] 杨春建[1] 

机构地区：[1]合肥市第二人民医院血管外科,安徽合肥230011

出　　处：《中国现代普通外科进展》2015年第1期23-25,38,共4页Chinese Journal of Current Advances in General Surgery

基　　金：合肥市重点课题基金资助项目(2013183)

摘　　要：目的：探索应用静脉腔内微创新技术诊治下肢交通静脉功能不全并发足靴区经久不愈或反复发作的溃疡的疗效。方法：对60例患者（共61条患肢）通过静脉造影和彩超检查发现患肢深静脉通畅,但有明显血液倒流,临床表现典型,都有经久不愈或反复发作的溃疡形成,临床分级为C5及C6级,在深、浅静脉间有扩大、曲张的交通静脉相通。全组患肢均作大隐静脉高位结扎＋腔内激光闭合术,并在超声引导下行交通支静脉腔内激光闭合。结果：全组患者手术顺利,术后症状和体征明显好转,无严重并发症发生。随访4-14个月,溃疡均未复发。结论：采用微创静脉腔内激光处理的新技术治疗本症,手术创伤轻微、并发症极少、疗效满意,明显优于内镜下交通支静脉离断术。Objective： Evaluation of ablation of incompetent perforation veins with a new and minimally invasive endovenous procedure on ulcer healing rates. Methods： From 2009-2013, 60patients（61 lower limbs）were admitted. All patiens in this group were classified in C5 and C6,with prominent dilation of the deep vein trunks and reflex. In all the 61 limbs, high-ligation of the saphenous vein and laser ablation of the saophenous vein in the thigh were made. And the perforation veins in the leg were puncture under the guide of duplex scanning for laser ablation. Result： thesymptoms were relieved after successful procedures. No severe complication. The follow-up was 4to 14 months, no ulcer recurred. Conclusion： Endovenous ablation of incompetent perforation veins is effective treatment with minimally-invasion and safety. This treatment is superior to subfascial endoscopic perforating surgery.

关 键 词：下肢静脉功能不全 交通静脉 溃疡形成 大隐静脉高位结扎 腔内激光闭合术 

分 类 号：R654.4[医药卫生—外科学]