大隐静脉转流术治疗髂股静脉栓塞

目的：总结大隐静脉转流术治疗髂股静脉栓塞的临床应用经验。方法：1998年9月至2005年12月，应用大隐静脉转流术治疗6例髂股静脉栓塞，男5例，女1例；年龄36~52岁，平均41岁；均为单侧股和小腿肿胀，伴有疼痛。从对侧切取正常的大隐静脉，经耻骨上隧道转移至患侧，在髂股静脉栓塞段以远与股静脉或大隐静脉近端吻合，将患侧静脉血经大隐静脉引流至对侧股静脉。结果：手术顺利，术后仅1例供区伤口发生表浅感染，经换药处理愈合。随访1—3．5年，平均1．8年，所有患者疼痛消失，水肿明显减轻，但仍有轻度肿胀。结论：大隐静脉转流术是治疗髂股静脉栓塞的有效方法。手术操作相对简单和安全。

Treatment of occluded iliofemoral veins with great saphenous vein cross-over bypasses

Objective: To summarize clinical application experience of treatment of occluded iliofemoral veins with great saphenous vein cross-over bypasses. Methods: From September 1998 to December 2005,6 patients(5 men,1 woman) with occluded iliofemoral veins underwent great saphenous vein cross-over bypasses. They ranged in age from 36 to 52 years (mean,41 years old). All patients had unilateral thigh and leg edema and swelling with accompanying pain. The normal contralateral great saphenous vein was dissected and it was tunneled across the super-pubic fat pad and anastomosed to the femoral vein or the proximal portion of great saphenous vein in distal to occluded iliofemoral veins. Results: The postoperative course was uneventful. One case sustained superficial infection postoperatively at donor site and the gradual wound healed by daily wound dressings. At 1 to 3.5 years(mean 1.8 years ) followed up,all patients had pain disappearance and obvious relief of the edema but some swelling. Conclusion: Great saphenous vein cross-over bypasses is effective operative method of treatment of occluded iliofemoral veins. The operation is relatively simple and safe.