内镜筋膜下交通支静脉离断术治疗下肢慢性静脉性溃疡的临床研究

目的：探讨内镜筋膜下交通支静脉离断术（subfascial endoscopic perforator vein surgery，SEPS）治疗下肢慢性静脉性溃疡的临床疗效。方法：收集2005年1月至2008年7月行SEPS术治疗下肢慢性静脉性溃疡患者91例（102条肢体），分析SEPS术治疗下肢慢性静脉性溃疡的疗效、术中情况、术后并发症及住院时间。结果：本研究组102条肢体行SEPS术前与术后的临床症状体征，除色素沉着外，均有明显改善（P<0.01）。SEPS手术组患者溃疡愈合率93.1%，复发率1.96%，伤口感染率1.0%。手术过程耗时短，术中出血量少，术后住院时间为（6.5±3.4） d，溃疡愈合时间为（12.2±13.7） d。结论：SEPS是目前治疗下肢慢性静脉性溃疡的简单、有效方法，尤其是对CEAP临床分级中C5，C6级患者疗效显著。

Treatment for chronic venous ulcerlation of the leg by subfascial endoscopic perforator vein surgery

ObjectiveTo observe the effect of subfascial endoscopic perforator vein surgery (SEPS) in the treatment of chronic venous ulceration of the legs.MethodsChronic venous ulceration for 91 patients with 102 limbs was treated by SEPS from January 2005 to July 2008. The effect of SEPS on chronic venous ulceration of the leg, the symptoms during and after the operation, and the durations of hospital treatment were analyzed. ResultsThe symptoms of the 102 legs conducted by SEPS operation, except the pigmentation, were obviously improved (P<0.01). Its cicatrisation rate, the recrudesce rate, and the cut infection rate were 93.1%,1.96%, and 1.0%, respectively. The time of the operation was short and the hemorrhage was small during the surgery. The durations of hospitalization and the cicatrisation time of ulceration were (6.5±3.4)d and (12.2±13.7)d， respectively. ConclusionSEPS is simple and effective in treating chronic venous ulceration of the leg, and particularly effective for patients classified into C5 and C6 in clinical-etiological-anatomical-pathophysiology (CEAP).