股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全疗效评价

目的　评价股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全的疗效和应用价值。方法　 97例 (97侧肢体 )经静脉顺行造影证实为原发性下肢深静脉瓣膜功能不全的患者分为A、B两组 ,A组 79例 ,B组 18例。A组行大隐静脉高位结扎剥脱术加交通支结扎术同时行股浅静脉瓣膜环形缩窄术 ,B组仅行大隐静脉高位结扎剥脱术加交通支结扎术。以CEAP临床分类与临床记分和顺行性下肢静脉造影评价疗效。结果　A、B两组术后临床记分均明显下降 (A组P <0 0 1;B组P <0 0 5 )。A组中C5～C6者手术效果较C2 ～C4者好 ;两组C2 ～C4者比较 ,A组手术效果优于B组。术后A组中 6 7侧患肢行顺行性下肢静脉造影 ,瓣膜功能恢复有效率为 83 5 8% (5 6 /6 7) ,显效率为 4 1 79% (2 8/6 7) ;B组 12侧患肢股浅静脉瓣膜功能恢复有效率为 33 33% ,两组有效率比较 ,有显著性差异 (P <0 0 5 )。结论　大隐静脉高位结扎加交通支结扎加股浅静脉瓣膜环形缩窄术 ,较大隐静脉高位结扎加交通支结扎术更有助于临床症状缓解和瓣膜形态功能的恢复。术前明确诊断为原发性下肢深静脉瓣膜功能不全患者 ,宜行股浅静脉瓣膜环形缩窄手术。     

股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全的疗效分析

目的评价股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全(primary deep venous insufficiency,PDVI)的疗效和应用价值。方法2002年4月至2006年4月期间经顺行性静脉造影加Valsalva试验证实为PDVI者119例(158条),其中2002年4月至2004年1月收治者仅行大隐静脉高位结扎剥脱 交通支结扎术(前期治疗组),2004年2月至2006年4月收治者在前期治疗方法的基础上加行股浅静脉瓣膜环形缩窄术(后期治疗组),以CEAP(clinical,etiologic,anatomic,and pathophysiologic)临床分级与临床记分评价2组的疗效。结果2组患者术后临床分级及临床记分均明显下降(前期治疗组由5.9±3.6降至2.1±1.3,P<0.01;后期治疗组由6.4±3.5降至1.7±1.8,P<0.01),且后期治疗组较前期治疗组下降程度更大(P<0.01)。结论股浅静脉瓣膜环形缩窄术有助于PDVI患者临床症状缓解,因此术前明确诊断为PDVI的患者,应行股浅静脉瓣膜环形缩窄手术。     

原发性下肢深静脉瓣膜功能不全手术方法的选择

目的观察不同手术方法治疗原发性下肢深静脉瓣膜功能不全的疗效。方法150例（240条肢体）经顺行静脉造影证实为原发性下肢深静脉瓣膜功能不全的患者分为A、B、C3组，每组80条患肢。A组行股浅静脉瓣膜外戴戒术，B组行股浅静脉瓣膜外修补术，C组行胭静脉半腱肌-股二头肌肌襻代瓣膜术，3组均同时行大隐静脉高位结扎剥脱术加交通支结扎术。以CEAP临床分级与临床记分评价疗效。结果3组术后临床记分呈不同程度下降：A组中C2-C4者手术效果较好；B组中C2～C4者手术效果较好；C组中C2-C6者手术效果较好；A、B、C3组手术效果比较，对C2～C4者，3组无明显差异；对C5，者，B、C组无明显差异，但A组效果较差；对C6者，C组效果较好，但A、B组效果较差。结论原发性股浅静脉瓣膜功能不全的手术治疗，应依据深静脉瓣膜功能不全的程度决定手术方式。     

术中超声辅助股浅静脉瓣膜戴戒术治疗下肢深静脉瓣膜功能不全

目的研究术中加用多普勒超声辅助股浅静脉瓣膜戴戒术治疗原发性下肢深静脉瓣膜功能不全(PDVI)的疗效和应用价值。方法对2001年6月起至2006年6月第四军医大学西京医院经静脉顺行造影证实为PDVI的87例临床资料进行分析。分为两组:A组(44例)行术中联合多普勒超声的股浅静脉瓣膜戴戒术加曲张静脉剥脱术。B组采用传统股浅静脉瓣膜戴戒术加曲张静脉剥脱术。以瓣膜返流持续时间评价即时效果,以癌胚抗原蛋白(CEAP)临床分类与临床记分做随访评价疗效。结果A组病人戴戒前后术中超声检测显示静脉瓣返流持续时间戴戒后较戴戒前明显缩短(P<0.01)。CEAP分组结果显示A组手术有效率达95.0%(38/40),B组有效率为76.7%(33/43),两组有效率比较差异有显著性意义(P<0.01)。A、B两组术后临床记分均明显下降,差异有显著性意义(P<0.01)。结论股浅静脉瓣膜戴戒术采用术中多普勒超声检查进行辅助能够有效提高手术的针对性,提高疗效。     

股静脉壁环形缩窄术治疗深静脉瓣膜功能不全

目的:观察股静脉壁环形缩窄术治疗原发性深静脉瓣膜功能不全(PDVI)治疗效果.方法:以股静脉壁环形缩窄术为主,选用大隐静脉高位结扎剥脱术、交通静脉结扎术、点式剥脱术、电凝术、环形缝扎术、硬化剂、活动性溃疡周边连续缝扎等综合治疗.结果:227例262条患肢,C3级78条患肢随访77条,肿胀完全消退或明显消退71条,6条肿胀略消退.C4级149条患肢随访147条,139条患肢色素沉着消失或明显缩小,5条略缩小,3条无明显变化.C5级19条患肢随访19条溃疡均无复发.C6级16条患肢11条手术后拆线时溃疡愈合,3条拆线后加强换药愈合,2条植皮后愈合,随访15条,14条未复发,1条复发后经治疗后愈合.结论:股静脉壁环形缩窄术治疗方法痛苦小,疗效可靠,能够立体治疗PDVI的目的.     

股浅静脉瓣膜缩窄术治疗下肢深静脉瓣膜功能不全临床分析

目的探讨股浅静脉瓣膜缩窄术治疗原发性下肢深静脉瓣膜功能不全(primary deep venous insufficiency,PDVI)的方法及其临床疗效。方法对2012-11—2014-11间收治的52例PDVI患者施行股浅静脉瓣膜缩窄术,回顾性分析患者的临床资料。结果52例患者均成功手术,切口均Ⅰ期愈合,未发生切口感染、淋巴漏、深静脉血栓形成等并发症。皮下瘀血者10例,对症处理后均于折线前吸收。随访1~2 a,浅静脉曲张消失,皮炎、脂质硬化、色素沉着等症状显著改善,溃疡均愈合。4例患者小腿仍轻度肿胀,穿医用弹力袜子后能够明显减轻。结论股浅静脉瓣膜缩窄术治疗PDVI能够显著改善患者临床症状,减轻痛苦,临床疗效满意。     

两种不同手术方式治疗原发性下肢深静脉瓣膜功能不全的对比研究

目的比较TriV ex旋切术联合腔内激光与大隐静脉高位结扎剥脱术联合股浅静脉戴戒术治疗原发性下肢深静脉瓣膜功能不全(PDVI)的疗效和并发症。方法将2010年2月至2014年7月本院收治CEAP分级为C4级以下108例PDVI患者(137条患肢),分为观察组(TriV ex旋切术联合腔内激光治疗)和对照组(传统大隐静脉高位结扎剥脱术联合股浅静脉戴戒术),对比观察两组临床疗效和术后并发症。结果患者肢体症状均不同程度缓解,有效率100%,两组手术方式均能明显改善症状和有效控制血液反流;观察组手术时间、住院时间、术中出血量、切口数和术后淋巴水肿比较结果优于对照组,差异有统计学意义(P0.05);切口感染、皮下瘀斑、硬结、皮肤麻木及深静脉血栓形成两组差异无统计学意义。结论两种手术方式均是治疗PDVI安全、有效的手段,但TriV ex旋切术联合腔内激光治疗术具有创伤小、恢复快,值得推广开展。     

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

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。     

原发性下肢深静脉瓣膜功能不全术后静脉压变化的研究

目的探讨股浅静脉戴戒术和单纯性静脉高位结扎加剥脱术治疗原发性下肢深静脉瓣膜功能不全(PDVI)后的下肢静脉压变化。方法收集2008年1月至2010年1月本院治疗的106例PDVI患者(121条患肢),分为股浅静脉戴戒术组(A组,51例患者,53条患肢)和单纯性浅静脉高位结扎加剥脱术组(B组,55例患者,68条患肢),在手术前、术后12天、1年和5年分别进行患肢足背静脉压测定。结果手术后1年:A组51例术前和术后静态静脉压(P0)为(127.80 cm H2O vs 126.55 cm H2O)和B组55例术前和术后静态静脉压(P0)为(126.70 cm H2O vs 125.80 cm H2O),两组均比较无统计学差异(P0.05),A组术前和术后运动后最低静脉压(Pmin)为(76.54 cm H2O vs 63.3 cm H2O),压力回升到静止静脉压水平90%时所需时间(RT90)为(8.20秒vs 18.60秒),和B组术前和术后Pmin(75.72 cm H2O vs75.10 cm H2O)与RT90(8.50秒vs 8.1秒)相比较,A组统计学有显著性差异(P0.01),B组无统计学差异(P0.05)。结论股浅静脉戴戒术在术后能有效的降低运动后静脉压最低值(Pmin),同时能延长压力回升到静止静脉压水平90%的时间(RT90)。     

原发性下肢深静脉瓣膜关闭不全的治疗

报道18例原发性下肢深静脉瓣膜关闭不全患者,采用股浅,隐-股静脉瓣膜戴戒术,大隐静脉高位属支结扎、主干曲张静脉剥脱术,小腿局部曲张浅静脉间断缝扎技术治疗。随访4～26个月,症状基本消失,皮炎明显好转。术后1～3角溃疡愈合。有3例作逆行 顺行静脉造影,显示1级瓣膜功能。     

戴戒术与单纯浅静脉剥脱术治疗原发性下肢深静脉瓣膜功能不全的比较

目的:比较股浅静脉戴戒术与单纯性浅静脉剥脱术治疗下肢深静脉瓣膜功能不全的疗效。方法:将2010年03月—2011年1月收治的48例下肢深静脉瓣膜功能不全伴静脉曲张患者随机分为观察组(股浅静脉戴戒术联合大隐静脉高位结扎剥脱术)和对照组(传统大隐静脉高位结扎剥脱术),通过彩色多普勒检测两组术前及术后股总静脉血管内径、平均血流速度及Valsalva试验下反流持续时间的变化。结果:与术前比较,术后两组患者的静脉瓣膜功能及血流动力学均明显改善,表现为股总静脉管径缩小、平均血流速度增快、静脉血流反流时间缩短(均P<0.05),但观察组上述3个变量手术前后变化程度(差值)均明显大于照组(均P<0.05)。结论:两种手术方式均是治疗下肢深静脉瓣膜功能不全的有效手段,但戴戒术的治疗效果优于单纯性浅静脉剥脱术。     

术中超声辅助下腔外瓣膜成形术治疗原发性下肢深静脉瓣膜功能不全

目的探讨术中超声辅助下腔外瓣膜成形术对原发性下肢深静脉瓣膜功能不全（PDVI）的治疗效果和应用价值。方法回顾性分析我院从2004年10月至2009年2月PDVI患者63例（74条肢体）,CEAP分级：C274条肢体,C317条肢体,C436条肢体,c513条肢体,C68条肢体。下肢顺行静脉造影提示深静脉返流Ⅱ～Ⅳ级,浅静脉迂曲扩张。在术中超声辅助下行腔外瓣膜成形术,同时行大隐静脉激光烧灼术及小腿交通静脉点状剥脱术。结果术后所有患者症状全部消失,下肢慢性溃疡者在2～4周愈合,色素沉着逐渐改善。术后6个月进行患肢VCSS评分,表明症状明显缓解,术后6个月复查彩超表明瓣膜成形处直径及返流时间与术前比较差异有统计学意义（P〈0．01）,48例患者术后随访1～5年无复发。结论术中超声辅助下腔外瓣膜成形术治疗PDVI,方法客观,疗效确切。     

腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全

目的 评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效.方法 150例下肢静脉功能不全患者(150条患肢)随机分为A、B两组,每组75例.A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术,B组行大隐静脉高位结扎抽剥术联合曲张浅静脉TriVex刨吸术.比较两组的手术时间、术后首次下床时间、术后48 h的疼痛视觉模拟评分(VAPS)值、术后住院天数、皮下血肿和皮下硬结的发生情况;比较患者对手术的自身评价、手术前后美国静脉联盟CEAP分级、临床严重程度计分(VCSS)、慢性静脉功能不全问卷(CIVIQ)生活质量评分的变化.结果 两组手术时间差异不显著,A组术后疼痛轻、下床时间早、住院天数少、皮下血肿发生率低,但皮下硬结发生率高于B组;术后4周对手术的评价A组优于B组;A、B手术前后CEAP分级、VCSS、CIVIQ评分变化差别有统计学意义(P<0.05),两组间VCSS分差、CIVIQ评分差异无统计学意义(P>0.05).结论 利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效,且微创、并发症少、更具人性化;CEAP临床分级、VCSS临床计分和CIVIQ生活质量评分可用于评价其疗效.     

Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity

OBJECTIVE: This study was conducted to verify the efficacy of external valvuloplasty of the femoral vein in the treatment of primary chronic venous insufficiency (PCVI). METHODS: Forty patients with PCVI of the bilateral lower extremities were enrolled at the time of surgical management. All 80 limbs were classified as CEAP C2 to C4, with moderate incompetence of the deep vein. The limbs of each patient were randomized into one of two groups according to the operative method, so that when one limb was randomized to group A, regardless of whether it was the right or left limb, the other limb was assigned to group B. In group A, external valvuloplasty of the femoral vein was combined with surgery of the superficial venous system; in group B, surgery of the superficial venous system alone was performed. The therapeutic effects between the limbs in groups A and B were compared by color duplex scanning, a color Doppler velocity profile, air plethysmography (APG), and a CEAP severity score at 1 month, 1 year, and 3 years postoperatively. RESULTS: Within each group of limbs, no significant differences were found in the average operative time within each group of limbs. The varicose veins resolved, there were no deep vein thromboses, and the wounds healed well postoperatively in all cases. Leg heaviness was relieved completely in 90% of group A limbs (36/40) and 55% of group B limbs (22/40). Venous valve competence was achieved in 100%, 98.1%, and 90.9% of group A limbs at 1 month, 1 year, and 3 years postoperatively, respectively. The amount of venous reflux, APG indices, and CEAP severity scores were not significantly different between the two groups preoperatively (P > .05). The amount of venous reflux, reflux indices, CEAP severity scores, and muscle pumping indices improved markedly in group A limbs postoperatively compared with group B limbs (P < .01); muscle pumping indices did not improve significantly in group B limbs postoperatively (P > .05). There were significant differences in the amount of venous reflux, reflux indices, and CEAP severity scores between group A and B limbs at 1 month and 1 year postoperatively (P < .01). There were significant differences in all parameters assessed between group A and B limbs 3 years postoperatively (P < .05). CONCLUSIONS: External valvuloplasty of the femoral vein combined with surgical repair of the superficial venous system improved the hemodynamic status of the lower limbs, restored valvular function more effectively, and achieved better outcomes than surgical repair of the superficial venous system alone.     

Clinical presentation and venous severity scoring of patients with extended deep axial venous reflux

BACKGROUND: The objective of this study was to evaluate the prevalence and profile of patients presenting with chronic venous insufficiency (class C3-C6) and cascading deep venous reflux involving femoral, popliteal, and crural veins to the ankle. METHODS: From September 2001 to April 2004, 2,894 patients were referred to our center for possible venous disorders. The superficial, deep, and perforator veins of both legs were investigated with color duplex scanning. The criterion for inclusion in this study was the existence of cascading deep venous reflux involving the femoral, popliteal, and crural veins to the ankle whose duration had to be longer than 1 second for the femoropopliteal vein and longer than 0.5 seconds for the crural vein. The advanced CEAP classification, the Venous Clinical Severity Score (VCSS), the Venous Segmental Disease Score (reflux; VSDS), and the Venous Disability Score (VDS) were used. RESULTS: Seventy-one limbs in 60 patients were identified. Eleven limbs (15.5%) were classified as C3, 36 (50.7%) as C4, 21 (29.6%) as C5, and 3 (4.2%) as C6. A primary etiology was identified in 11 (15.5%) limbs, and a postthrombotic etiology was identified in 60 limbs (84.5%). In the latter group, all but four patients were aware that they had had a previous deep venous thrombosis. In addition to femoropopliteal and calf veins, reflux was present in the common femoral vein in 60 (84.5%), the deep femoral vein in 27 (38%), and the muscular calf veins in 62 (87.3%). Incompetent perforator veins were identified in 53 (74.6%) limbs. Fifty-one (71.8%) limbs had a combination of superficial venous insufficiency (AS(2), AS(2,3), AS(4), or their combination) previously treated or present. Of these, 11 had primary etiology alone, and 40 had a secondary etiology with or without primary disease. Means and 95% confidence intervals of the VCSS, VSDS, and VDS were 9.72 (8.91-10.53), 7.2 (6.97-7.42), and 1.08 (0.83-1.32), respectively. A significant increase in the VCSS and in the VSDS (P < .0001) paralleled the CEAP clinical class. The VDS was higher in the C3 and C6 classes but did not reach significance. There was a significant link between the pain magnitude in the VCSS and the VDS (P < .0001). Severity of pain and high VDS did not depend on the wearing of elastic compression stockings. VCSS increased significantly according to the presence of an incompetent perforator vein (P < .05) and/or reflux in the deep femoral vein (P < .05). CONCLUSIONS: This study confirmed the value of the Venous Severity Score as an instrument for evaluation of chronic venous insufficiency. A significant increase in the VCSS and VSDS paralleled CEAP clinical class; VDS was higher in classes C3 and C6 without reaching significance, probably because of the small size of the samples. Some clinical and anatomic features need to be clarified to facilitate scoring.     

Deep axial reflux, an important contributor to skin changes or ulcer in chronic venous disease

OBJECTIVE: We undertook this cross-sectional study to investigate the distribution of venous reflux and effect of axial reflux in superficial and deep veins and to determine the clinical value of quantifying peak reverse flow velocity and reflux time in limbs with chronic venous disease. PATIENTS AND METHODS: Four hundred one legs (127 with skin changes, 274 without skin changes) in 272 patients were examined with duplex ultrasound scanning, and peak reverse flow velocity and reflux time were measured. Both parameters were graded on a scale of 0 to 4. The sum of reverse flow scores was calculated from seven venous segments, three in superficial veins (great saphenous vein at saphenofemoral junction, great saphenous vein below knee, small saphenous vein) and four in deep veins (common femoral vein, femoral vein, deep femoral vein, popliteal vein). Axial reflux was defined as reflux in the great saphenous vein above and below the knee or in the femoral vein to the popliteal vein below the knee. Reflux parameters and presence or absence of axial reflux in superficial or deep veins were correlated with prevalence of skin changes or ulcer (CEAP class 4-6). RESULTS: The most common anatomic presentation was incompetence in all three systems (superficial, deep, perforator; 46%) or in superficial or perforator veins (28%). Isolated reflux in one system only was rare (15%; superficial, 28 legs; deep, 14 legs; perforator, 18 legs). Deep venous incompetence was present in 244 legs (61%). If common femoral vein reflux was excluded, prevalence of deep venous incompetence was 52%. The cause, according to findings at duplex ultrasound scanning, was primary in 302 legs (75%) and secondary in 99 legs (25%). Presence of axial deep venous reflux increased significantly with prevalence of skin changes or ulcer (C4-C6; odds ratio [OR], 2.7; 95% confidence interval [CI], 1.56-4.67). Of 110 extremities with incompetent popliteal vein, 81 legs had even femoral vein reflux, with significantly more skin changes or ulcer, compared with 29 legs with popliteal reflux alone (P =.025). Legs with skin changes or ulcer had significantly higher total peak reverse flow velocity (P =.006), but the difference for total reflux time did not reach significance (P =.084) compared with legs without skin changes. In contrast, presence of axial reflux in superficial veins did not increase prevalence of skin changes (OR, 0.73; 95% CI, 0.44-1.2). Incompetent perforator veins were observed as often in patients with no skin changes (C0-C3, 215 of 274, 78%) as in patients with skin changes (C4-C6, 106 of 127, 83%; P =.25). CONCLUSION: Continuous axial deep venous reflux is a major contributor to increased prevalence of skin changes or ulcer in patients with chronic venous disease compared with segmental deep venous reflux above or below the knee only. The total peak reverse flow velocity score is significantly higher in patients with skin changes or ulcer. It is questionable whether peak reverse flow velocity and reflux time can be used to quantify venous reflux; however, if they are used, peak reverse flow velocity seems to reflect venous malfunction more appropriately.     

A rational approach to surgery of the chronic venous statis syndrome.

Ambulatory venous pressure (AVP) and ascending and retro-grade phlebography have been used to elucidate the precise pathogenetic factors in cases of venous stasis. On the bases of this information, procedures aimed at the correction of the particular pathophysiological alterations were carried out. Fifty-two lower extremities in 49 patients suffering from chronic venous statis were studied. The AVP was performed by having the patient walk in place for 15 seconds without tourniquet and with one or two tourniquets at different levels of the extremity. The per cent drop of pressure in a foot vein during exercise and the time to return to standing pressure were used to determine a venous sufficiency index. Four distinct factors or groupings could be distinguished: incompetent perforators (31), deep vein incompetence (14), incompetence of the saphenous vein (3), and obstruction of deep veins (4). Six types of surgical procedures were done: ligation of perforators (25), superficial femoral valvuloplasty (3), segmental venous transposition (1), ligation of the superficial femoral vein (1), cross femoral venous bypass (1) and high ligation and stripping of the long saphenous vein (3). Three patients had skin sloughing after perforator ligation, and one patient developed a hematoma requiring evacuation following segmental venous transfer. Post-operative AVP evaluation in 11 patients after perforator ligation, two patients following superficial femoral valvuloplasty, one patient after segmental venous transfer, and one patient after cross femoral venous bypass showed significant improvement. Early follow-up results are very satisfactory.     

两种不同术式治疗下肢静脉功能不全的近期疗效对照研究

目的 评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效. 方法 150例下肢静脉功能不全患者(150条患肢)随机分为A、B两组,每组75例.A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术,B组行大隐静脉高位结扎抽剥术联合曲张浅静脉TriVex刨吸术.比较两组手术情况、术后4周患者对手术的自身评价、手术前后CEAP(clinic,etiologic,anatomic and pathophysiological classification)分级和临床严重程度计分(venous clinical severity score,vcss)的变化.结果 A、B两组手术时间分别为(67±11)min和(69±9)min(P＞0.05),A组术后疼痛轻、下地时间早、住院天数少、皮下血肿发生率低,但皮下硬结发生率高于B组;对手术的评价A组为(11.21±2.00)分优于B组(10.52±2.08)分,差异有统计学意义(P＜0.05);两组手术前后CEAP分级和VCSS计分变化差异均有统计学意义(P＜0.01),A、B两组手术前后VCSS分差为(4.6±2.5)分和(4.3±2.7)分(P＞0.05).结论 利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效,且微创、并发症少.CEAP临床分级和VCSS临床记分可用于其疗效评价.     

腔内激光治疗静脉曲张的探讨

摘要：目的: 探讨腔内激光(EVLT)联合手术个性化治疗静脉曲张的综合方法。方法:下肢慢性静脉功能不全（CVI）285例（295条患肢），根据临床表现和双功超声、静脉造影，基于CEAP分期，分为A，B，C 3组，采取3种手术方式进行治疗。A组用单纯腔内激光闭塞术;B组用腔内激光加点式结扎；C组用股浅静脉包窄术加腔内激光加点式结扎。结果:全组曲张浅静脉均消失，皮肤颜色变浅，肿胀改善，溃疡愈合或缩小。结论:EVLT技术治疗下肢浅静脉曲张是有效的微创手术治疗方法，只要根据CEAP分期，通过标准化的诊断，选择好适应证，采用EVLT联合其他手术治疗原发性下肢深静脉瓣膜功能不全是可行和有效的。