内镜深筋膜下交通静脉离断术治疗下肢严重慢性静脉功能不全疗效分析

目的探讨内镜深筋膜下交通静脉离断术（SEPS）对严重慢性静脉功能不全（CVI）患者的疗效。方法53例CEAP（临床表现、病因学、解剖学、病理生理学）分级C4以上下肢严重CVI患者分为2组，其中25例单纯行大隐静脉高位结扎＋抽剥术（A组），28例行SEPS联合大隐静脉高位结扎＋抽剥术（B组）。术后随访1．2年，比较2组的疗效。结果2组间症状改善率、CEAP分级改善率、溃疡愈合率差异均无统计学意义（P〉0．05）。与A组比较，B组溃疡愈合时间明显缩短，溃疡复发率明显降低（P〈0．05）。2组术后并发症发生率及术后住院时间差异均无统计学意义（P〉0．05）。结论SEPS对下肢严重CVI疗效满意，具有一定的临床应用价值。

Efficacy of subfascial endoscopic perforator surgery for advanced chronic venous insufficiency of lower extremities

Objective To explore the therapeutic effect of subfascial endoscopic perforator surgery （SEPS） for advanced chronic venous insufficiency （CVI）. Methods 53 advanced CVI patients with CEAP （clinical severity, etiolo- gy, anatomy, and pathophysiology） classification CA and above were divided into two groups. High ligation plus stripping of great saphenous vein was performed in 25 patients （ Group A） . SEPS combined with high ligation plus stripping of great saphenous vein was performed in 28 patients （ Group B） . Patients in both groups were followed up for 1 - 2 years after operation and the therapeutic effects were compared. Results There were no statistically significant differences in the rates of symptomatic improvement, CEAP （ clinical severity, etiology, anatomy, and pathophysiology） classification improvement and ulcer healing between the two groups （P 〉 0.05 ）. Compared with group A, group B had significantly shorter ulcer healing time and lower ulcer relapse rate （ P 〈 0.05 ）. There were no statistically significant differences in the rate of postoperative complications and the length of postoperative hospital stay between the two groups （ P 〉 0.05 ）. Conclusion SEPS is a safe and effective procedure in treating advanced CVI and has certain value in clinical application.