下肢静脉淤积性溃疡的激光微创综合治疗  

The comprehensive mini-invasive laser treatment in patients with leg varicose ulcer

作　　者：王春喜[1] 曾晶[2] 王晓玲[3] 顾瑛[2] 孙长江[3] 金梅[3] 

机构地区：[1]解放军总医院普通外科,北京市100853 [2]解放军总医院激光医学科,北京市100853 [3]北京市长峰医院普通外科

出　　处：《中国激光医学杂志》2014年第6期319-322,共4页Chinese Journal of Laser Medicine & Surgery

基　　金：军队十五指令计划基金资助(Ol L020)

摘　　要：目的探讨激光微创治疗下肢静脉瘀积性溃疡的治疗方法。方法回顾性分析2005年1月至2013年6月,下肢静脉瘀积性溃疡患者35例的临床资料,采用溃疡周围交通支静脉、皮瓣下穿支静脉激光光凝、溃疡周围交通支静脉缝扎术,并对7例合并深静脉瓣膜功能不全者同时行小切口瓣膜修复。术后患肢加压包扎、溃疡局部清洁换药,促进愈合。结果 35例患者术后1个月下肢曲张浅静脉完全消失,溃疡均明显好转;术后3个月溃疡完全愈合22例,治愈率62.9%;术后6个月溃疡完全愈合32例,治愈率91.4%;术后1年35例患者溃疡全部愈合,下肢静脉无曲张,均达到临床治愈标准。术后随访溃疡复发：术后1~2年7例无复发;术后3~5年12例无复发;术后满5年以上者16例,其中15例获得随访,1例失访,1例术后7年死于急性心肌梗塞,1例术后6年复发。结论激光微创治疗溃疡周围异常返流的交通支静脉,辅以点状切开缝扎或结扎溃疡交通静脉的方法,可用于下肢静脉瘀积性溃疡的治疗,中远期疗效较好。Objective To investigate the comprehensive mini-invasive therapy with endovascular laser treatment in patients with leg varicose ulcer. Methods The 35 patents data were collected retrospectively from January 2015 to June 2013, who suffered from chronic leg varicose ulcer for many years and received comprehensive mini-invasive therapy with endovascular laser coagulation and local suture. The local venous Valve repair was done in 7 patients with primary deep venous insufficiency simultaneously. The pressure dressings were done post operation and the ulcer management was carefully done with vaseline gauze. Results The venous ulcers were better improved and the varicosities were disappeared post 1 month operation. The 22 case ulcers were healed post 3 month operation and 32 case ulcers were healed among 32 cases. All cases were cured post 1 year operation. The 5 years followed-up results were better, all cases were cured except 1 case were recurrence post 6 years operation and 1 case was died of acute myocardial infarction post 7 years operation. Conclusions The comprehensive mini-invasive therapy with endovascular laser treatment could be used for treating patients with leg varicose ulcer, and its middle-term and long-term results were better.

关 键 词：激光 静脉溃疡 微创治疗 

分 类 号：R543.6[医药卫生—心血管疾病]