腘静脉肌袢代瓣术治疗重度原发性下肢深静脉瓣膜功能不全的疗效分析
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Analysis of substitue valve in popliteal vein for |treatment of primary deep venous insufficiency of lower extremity
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    摘要:

    目的:研究腘静脉肌袢代瓣术进行深静脉瓣膜重建对重度原发性下肢深静脉瓣膜功能不全(PDVI)的疗效。
    方法:选取106例CEAP分级4级以上患者,随机分为肌袢代瓣联合浅静脉手术组和单纯浅静脉手术组,对比两组术前、术后14 d及术后2年的静脉疾病临床严重度评分(VCSS)。
    结果:两组术后14 d VCSS总分及疼痛、静脉曲张、炎症及溃疡评分均较术前明显下降(P<0.05),但组间比较差异无统计学意义(P>0.05)。术后2年VCSS总分[(3.5±1.8)vs.(4.7±3.1),P=0.039]、静脉曲张(P=0.026)与水肿(P=0.021)评分肌袢组较单纯浅静脉组显著下降。
    结论:对CEAP分级4级以上,且合并严重静脉水肿的PDVI患者,肌袢代瓣术联合浅静脉剥脱术远期疗效优于单纯浅静脉手术。

    Abstract:

    Objective:To investigate the therapeutic effect of deep venous valve reconstruction using substitute valve in popliteal vein of patients with severe primary deep venous insufficiency (PDVI).
    Methods:One hundred and six PDVI patients with CEAP classification of 4 to 6 class were included and randomly assigned as observation group and control group. Patients in the observation group underwent the combined treatment of substitute valve operation and superficial vein phlebectomy, and patients in the control group underwent superficial vein phlebectomy alone. The venous clinical severity scores (VCSS) of patients of the two groups were compared before surgery and 14 days and 2 years after surgery.
    Results:The total VCSS,scores for pain, varicosity, inflammation and ulcer of all patients obviously decreased 2 weeks after surgery (P<0.05), but no difference was noted between the two groups (P>0.05). The total VCSS, and scores for varicosity and edema in the observation group were significantly lower than those in the control group (P=0.039, P=0.026 and P=0.021, respectively) 2 years after surgery.
    Conclusions:For PDVI patients with CEAP classification of 4 to 6 class and complicated with severe venous edema, the combined treatment of substitute valve operation and superficial vein phlebectomy is better than superficial vein phlebectomy alone in long-term outcome.

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符洋|郭学利|王子凡|宋燕|张勇敢|苗超峰|白华龙.腘静脉肌袢代瓣术治疗重度原发性下肢深静脉瓣膜功能不全的疗效分析[J].中国普通外科杂志,2011,20(6):585-588.
DOI:10.7659/j. issn.1005-6947.2011.06.008

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  • 收稿日期:2011-03-07
  • 最后修改日期:2011-05-28
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  • 在线发布日期: 2011-06-15