腔镜下静脉交通支离断术治疗下肢静脉交通支瓣膜功能不全(附17例分析)

目的:探讨腔镜下静脉交通支离断术(SEPS)治疗下肢静脉交通支瓣膜功能不全的可行性。方法:2007年4月-2008年12月,经静脉造影诊断下肢静脉交通支瓣膜功能不全患肢17条,行SEPS术在深筋膜下断离病变交通支,联合Muller术抽剥浅表静脉以及行传统大隐静脉高位结扎+抽剥术。结果:17条患肢术后创口生长良好,无感染及出血,术后所有患肢曲张静脉团消失,局部疼痛缓解,7条患肢内踝沉着色素减轻,5条患肢溃疡在2~4周内完全愈合,无溃疡复发及新溃疡形成,术后无组织水肿。结论:腔镜下静脉交通支离断术(SEPS)治疗下肢静脉交通支瓣膜功能不全、下肢静脉溃疡具有创伤小、手术彻底、患者住院时间短的优点。

Subfascial Endoscopic Perforator Vein Surgery for Lower Limb Perforating Valve Insufficiency

Objective：To evaluate feasibility of subfascial endoscopic perforator vein surgery（SEPS） for treatment of valves insufficiency of the lower limbs venous perforator.Methods：Marking the placement of the insufficiency of lower limbs venous perforators by ascending phlebography in 17 sick limbs from April 2007 to December 2008.17 limbs accepted SEPS to cut the insufficiency of venous perforators under the deep fascia,combining Muller＇s phlebectomy to strip the superficial and the tradition great saphenous vein phlebectom.Results：All postoperative wound grow well,with no infection and bleeding.All limbs varicose veins disappeared and partial pain reliefed,7 limb pigmentation lightened,5 limb ulcers completely healed in 2 to 4 weeks,without ulcer recurrence and new ulcers formation.Conclusion：SEPS for treatment of lower extremity venous valvular dysfunction traffic and lower extremity venous ulcers had the advantages of minimal trauma,effective treatment and rapid recovery.