复发性下肢静脉曲张的治疗  

Treatment of recurrence of varicose veins of lower extremities

作　　者：黄晨[1] 郑晓兵[1] HUANG Chen;ZHENG Xiao-bing(Department of Vascular Surgery,Affiliated Hospital of Nantong University,Nantong 226000,China)

机构地区：[1]南通大学附属医院血管外科,江苏南通226000

出　　处：《中国血管外科杂志（电子版）》2018年第2期117-119,123,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的分析下肢静脉曲张术后复发原因及相应的处理原则。方法回顾性分析本院2010年1月至2017年12月收治的58例复发性下肢静脉曲张患者的临床资料。通过经皮足背静脉造影明确下肢静脉曲张的发病原因,再针对复发原因行对应的治疗。结果静脉曲张复发的原因为大隐静脉的残留28例(48.3%)、小隐静脉曲张3例(5.2%)、交通支瓣膜功能不全15例(25.9%)、左髂静脉受压综合征8例(13.8%)、深静脉血栓形成后综合征1例(1.7%)、布加综合征2例(3.4%)、K-T综合征1例(1.7%)。根据复发的原因行相应的治疗,技术成功率100%。术后随访复发率为3.4%,患者症状和生活质量明显改善,静脉临床严重程度评分从术前的10.4±2.6降低到术后的3.6±1.4(P<0.001),静脉疾病生活质量评分从术前的35.0±4.7降低到术后的9.8±2.8(P<0.001)。结论下肢静脉曲张复发原因各异,治疗方法是消除下肢静脉高压的病因,从而获得满意的疗效。Objective To analyze the causes and treatment principle of recurrence of varicose vein of lower extremities after surgery and describe the corresponding. Methods From January 2010 to December 2017, 58 patients with recurrent varicose vein after surgery treated in our hospital were retrospectively analyzed. Transdermal dorsal venography was used to confirm the main cause for the recurrence. The corresponding treatment for the cause of recurrence was performed thereafter. Results Causes of recurrence of varicose vein were the presence of residual great saphenous vein （28 patients, 48.3%）, varicose of small saphenous vein （3 patients, 5.2%）, deep venous valve dysfunction （15 patients, 25.9%）, May-Turner syndrome （8 patients, 13.8%）, post-thrombotic syndrome （1 patients, 1.7%）, Budd- Chiari syndrome （2 patients, 3.4%） and Klippel - Trenaunay syndrome （1 patients, 1.7%）. The Technical success rate was 100% and recurrence rate was 3.4% in the follow-up. VCSS score was reduced from 10.4± 2.6 pre-operation to 3.6±1.4 post-operation （P〈0.001） while AVVQ score was reduced from 35.0± 4.7 pre- operation to 9.8±2.8 post-operation （P〈0.001）. Conclusion The causes of recurrent varicose vein are different. The treatment principle is to eliminate the cause of lower venous hypertension.

关 键 词：下肢静脉曲张 复发 下肢深静脉造影 

分 类 号：R654.4[医药卫生—外科学]