开放性瓣膜修复术治疗下肢原发性深静脉瓣膜功能不全的疗效分析  

Open valvuplasty in trearment of primary deep venous valve insufficiency

作　　者：齐立行[1] 吴英锋[1] 佟铸[1] 齐一侠[1] 吴中俭 谷涌泉[1] 郭连瑞[1] Qi Lixing;Wu Yingfeng;Tong Zhu;Qi Yixia;Wu Zhongjian;Gu Yongquan;Guo Lianrui(Department of Vascular Surgery,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院血管外科,北京100053

出　　处：《血管与腔内血管外科杂志》2021年第9期1019-1022,共4页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨开放性瓣膜修复术治疗下肢原发性深静脉瓣膜功能不全(PDVVI)的疗效。方法收集2018年5月至2020年12月首都医科大学宣武医院17例行开放性瓣膜修复术治疗PDVVI的患者临床资料。患者按股浅静脉瓣膜损伤情况采取相应的开放性瓣膜修复术,9例采用股浅静脉切开瓣膜修复联合静脉壁外戴戒术;5例采用单纯股浅静脉戴戒术;3例采用自体腋静脉瓣膜股浅静脉移植术。术后随访,根据患肢基本临床表现恢复情况及静脉病变临床严重程度评分(VCSS)结果判断疗效。结果术后6个月临床治疗有效率为94.1%,与术后12个月的90.0%比较,差异无统计学意义(P>0.05)。术后6个月VCSS评分为(4.3±1.3)分,与术后12个月的(4.5±1.6)分比较,差异无统计学意义(P>0.05)。术后6、12个月VCSS评分均低于术前的(20.9±4.7)分,差异有统计学意义(P<0.01)。结论开放性下肢深静脉瓣膜修复术安全有效,根据瓣膜损伤情况采取相应的术式及规范的操作是手术成功的保证。其长期疗效尚待大样本临床研究进行评估。Objective To evaluate the effectiveness of open valvuloplasty for treating primary deep venous valve insufficiency(PDVVI).Method The clinical data of 17 patients underwent open valve repair for PDVVI in Xuanwu Hospital of Capital Medical University from May 2018 to December 2020 were collected.The patients were treated with open valve repair according to the injury of superficial femoral vein valve,9 cases were treated with superficial femoral vein incision and valve repair combined with external ring wearing;5 cases with simple ring-wearing in superficial femoral vein,and 3 cases with autologous axillary vein valve to superficial femoral vein transplantation.The effectiveness was judged according to the recovery of basic clinical manifestations of the affected limb and the results of venous clinical severity score(VCSS).Result The clinical effective rate was 94.1%at 6 months after operation,and there was no significant difference compared with 90.0%at 12 months after operation(P>0.05).The VCSS score was(4.3±1.3)at 6 months after operation,and there was no significant difference compared with(4.5±1.6)at 12 months after operation(P>0.05).The VCSS scores at 6 and 12 months after operation were significantly lower than those before operation(20.9±4.7)(P<0.01).Conclusion Open venous valvuloplasty is safe and effective.Optimal recruitment of surgery protocol according to venous valve conditions and standardized surgical operations are necessary for surgical success,but the long-term effectiveness of open venous valvuloplasty needs to be evaluated by large sized clinical study.

关 键 词：深静脉瓣膜功能不全 瓣膜修复术 静脉壁外戴戒术 瓣膜移植 

分 类 号：R543[医药卫生—心血管疾病]