腘静脉肌袢成形术治疗下肢深静脉瓣膜功能不全  

SUBSTITUTE VALVE AT POPLITEAL VEIN IN TREATING DEEP VENOUS VALVE INSUFFICIENCY OF LOWER EXTREMITIES

作　　者：尹乐平[1] 冯超[1] 顾毅[1] 刘彤[1] 

机构地区：[1]四川省人民医院血管外科,成都610072

出　　处：《中国修复重建外科杂志》2004年第1期46-48,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　研究下肢静脉肌袢成形术治疗下肢深静脉瓣膜功能不全的临床疗效。　方法　 1997年1月～ 2 0 0 1年 6月 ,选择经过彩色多谱勒、静脉造影确诊为原发性下肢深静脉瓣膜功能不全的 2 7例 (2 7条 )下肢 ,病程2～ 32年 ,平均 17.4年。均有浅静脉曲张 ;其中小腿沉重感 2 5例 ;肿胀 2 2例 ;足靴区色素沉着 2 5例 ;单侧慢性溃疡 19例 ;2例曾行单纯大隐静脉结扎剥脱术。静脉压静息直立时平均为 (11.0 0± 0 .73) k Pa,活动后平均为 (9.14± 0 .6 8) k Pa。均行静脉肌袢成形术 ,同时行大隐静脉高位结扎抽剥术 ,有 12例行腔镜下交通支结扎。　结果　术后 2 7条患肢静脉压活动后平均下降为 (5 .94± 0 .82 ) k Pa。与术前活动后平均值比较 ,差异有统计学意义 (P<0 .0 1)。近期疗效良好 ,小腿沉重感及肿胀完全或基本消失 ,溃疡创面在 2周内愈合。术后 2 2条患肢获 2～ 6年随访 ,2 1条患肢疗效优良 ,无复发 ;1例随访 3年时因肌袢粘连导致小腿深静脉血栓形成。　结论　严格掌握适应证 ,规范手术操作 ,静脉肌袢成形术治疗下肢深静脉瓣膜功能不全 ,可获得满意效果。Objective To study the effectiveness of substitute valve at the popliteal vein in treatment of deep venous valve insufficiency of lower extremities. Methods From January 1996 to August 2002, 27 patients were diagnosed having deep venous valve insufficiency of lower extremities by color Doppler and radiography with an average disease course of 17.4 years.All 27 patients had varicose vein, 25 pain, 22 swelling,25 pigmentation in ankle area and 19 chronic ulcerations.Two cases had been treated with great saphenous vein ligation and striping.Average vein pressure in resting position was (11.00±0.73)kPa,and the ambulatory venous pressure was (9.14±0.68)kPa.All patients were treated with substitute valve at the popliteal vein,and great saphenous vein ligation and stripping, some were treated with subfascial endoscopic perforating veins ablation. Results The average ambulatory venous pressure after operation was (5.94±0.82)kPa,were significantly different from that before operation(P<0.01). The curative results were satisfactory,and all symptom and physical sign disappeared.After a mean follow-up period of 2-6 years,21 cases had satifactory results. Conclusion Substitute valve at the popliteal vein have the value of widespread application.

关 键 词：腘静脉肌袢成形术 手术治疗 下肢深静脉瓣膜功能不全 手术适应证 

分 类 号：R654.4[医药卫生—外科学]