小腿静脉畸形并跟腱挛缩的手术治疗  

Surgery of venous malformation of the calf complicated by achilles tendon contracture

作　　者：张源方 孙斌 雷红召 朱晓爽 刘大看 董长宪 Zhang Yuanfang;Sun Bin;Lei Hongzhao;Zhu Xiaoshuang;Liu Dakan;Dong Changxian(Department of Hemangiomatology,Henan Provincial People’s Hospital,People’s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院郑州大学人民医院血管瘤科,郑州450003

出　　处：《中国实用医刊》2021年第3期1-4,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目(201702202)。

摘　　要：目的探讨手术治疗小腿静脉畸形并跟腱挛缩的临床效果。方法回顾性分析2016年3月至2018年3月于河南省人民医院进行手术治疗的43例小腿部静脉畸形并跟腱挛缩患者的病历资料,患者均采用小腿部静脉畸形手术切除,根据术中情况必要时加用"Z"形跟腱延长术,手术后进行康复锻炼,统计并评价手术成功率及治疗效果。结果43例患者中,35例小腿部瘤体完全切除;8例患者由于瘤体范围较广,瘤体侵袭包绕小腿胫后动静脉、胫后神经、腓总神经等,采取部分瘤体切除术;32例患者手术切除瘤体后联合行"Z"形跟腱延长术。随访6~12个月后发现,一期手术成功率为93%(40/43);43例患者均可正常行走,其中3例踝关节活动有轻度受限;35例术后小腿部疼痛消失,无肿块隆起,复查彩超、磁共振成像显示原瘤体部位未见复发,8例术后彩超、磁共振成像显示有散在瘤体存在,偶有疼痛症状。结论小腿部静脉畸形并跟腱挛缩患者行手术治疗可纠正踝关节功能,术后效果良好。Objective To investigate the clinical effects of surgery on venous malformation of the calf complicated by achilles tendon contracture.Methods The clinical data of 43 patients with venous malformation of the calf complicated by achilles tendon contracture treated in Henan Provincial People’s Hospital from March 2016 to March 2018 were analyzed retrospectively.All the patients were treated by surgical resection of venous malformation of the calf;according to the intraoperative situation,the Z-shaped achilles tendon lengthening was added if necessary.Rehabilitation exercise was carried out after the operation.The success rate and effect of operation were evaluated.Results Among all 43 patients,35 cases of tumor in calf were completely removed,8 patients underwent partial tumor resection because of the wide range of tumor,tumor invading and wrapping the posterior tibial artery and vein,posterior tibial nerve,common peroneal nerve.And 32 of 35 patients with complete resection were given Z-shaped achilles tendon lengthening after tumor resection.After a follow-up of 6 to 12 months,it was found that the successful operation rate in the first stage was 93%(40/43).All the 43 patients could walk normally,among which 3 cases had slight limitation of ankle movement.The pain in the calf disappeared after surgery in 35 cases,and there was no swelling.Color Doppler ultrasound and magnetic resonance imaging showed no recurrence at the site of the primary tumor.Color Doppler ultrasound and magnetic resonance imaging showed scattered tumor in 8 cases,with occasional pain symptoms.Conclusions The patients with venous malformation of the calf complicated by achilles tendon contracture should receive surgical treatment as soon as possible to correct ankle joint function,and the postoperative effect is good.

关 键 词：静脉 畸形 跟腱挛缩 手术 

分 类 号：R657.2[医药卫生—外科学] R654.4[医药卫生—临床医学]