下肢深静脉功能不全诊治的实验和临床研究

目的研究治疗不同程度下肢原发性深静脉瓣膜功能不全的有效方法。方法①观察以自体大隐静脉片、自体阔筋膜片和人造血管片作深静脉瓣膜包窄术的效果；②分别采用股或静脉瓣修复加包窄术、股或（和）静脉瓣包窄术、股浅静脉瓣修复和包窄加静脉瓣包窄术、自体带瓣腋静脉段静脉移植外加人造血管环包术、股静脉瓣包窄加静脉外代瓣术、静脉外代瓣术，共治疗１２１例（１３３条患肢）；③以静脉插管造影和彩色多普勒超声检查作为诊断和评估疗效的观察指标。结果①以膨体聚四氟乙烯人造血管片作包窄材料的效果最好；②彩超检查与静脉造影比较准确率为９１８６％；③本组患者平均随访３７８年，治愈率９１７３％。结论治疗下肢深静脉瓣膜功能不全，应根据病情选用不同的手术方法。

Experimental and clinical studies of deep venous incompetence of lower limbs

Objective To evaluate different operative procedures for different degree incompetence of the deep veins in lower limbs. Methods Analysis was made for the data of 121 patients with deep venous incompetence of lower limb in 133 limbs who underwent different operations as follows: strips of autogenous saphenous vein, autogenous fascia lata and PEFE graft were used as the materials of valve constriction respectively; including femoral or popliteal valve repair and constriction, femoral or popliteal valve constriction, femoral and popliteal valve constriction, superficial femoral valve repair and valve constriction, superficial femoral valve repair and constriction plus popliteal valve constriction, popliteal transplantation of autogenous valve bearing axillary vein segment with wrapping PTFE graft, femoral vave constriction substitute valve on popliteal vein and substiute valve on popliteal vein etc. Duplex scanning and transpopliteal venography were used as the main methods in assessment of the operation effects. Results PTFE strip is the best material for valve constriction; the accurate rate of duplex scanning compared to transpopliteal venography was 91.86%; the patients in this series were followed up with a mean period of 3.78 years with a satisfactory rate of 91.73%. Conclusions In the treatment of deep venous incometence of the lower limb, the choice of the operative procedure should accord to the condition of limbs' disease.