腔内激光+高位结扎+戴戒术治疗PDVI分析

目的：探讨腔内激光加高位结扎加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的疗效和应用价值．方法：经静脉造影等检查后，诊断为原发性下肢深静脉瓣膜功能不全患者24例（29条下肢）予以腔内激光治疗、大隐静脉高位结扎加股浅静脉瓣膜戴戒术治疗．结果：本组所有病例的下肢曲张浅静脉手术后均闭塞、消失，彩色超声多普勒检查示大隐静脉主干均发生血栓性闭塞．11条肢体（37．9％）发生沿大隐静脉行程条索状硬结或硬块，2条肢体（6．9％）出现淤斑，1例（3．4％）患者发生皮肤浅表烧伤．全组病例术后随访12～36mo，症状完全消失及明显减轻的下肢23条（79．3％），患肢溃疡愈合11条（73．3％），病情好转，症状基本消失但有轻度肿胀2条（6，9％），术后出现深静脉血栓形成者1条（3．4％）．结论：腔内激光加高位结扎加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的疗效满意，实用性强，具有安全、微创、瘢痕小和恢复快的优点．

Analysis on indirect loop valvuloplasty plus endovenous laser treatment plus high ligation in the treatment of pri- mary deep venous valve insufficiency in lower limb

AIM: To evaluate the therapeutic effect and clinical value of indirect loop valvuloplasty plus endovenous laser treatment plus high ligation in the treatment of primary deep venous insufficiency (PDVI) in lower limb. METHODS: Twenty-four patients (29 limbs) with PDVI diagnosed by venography were treated by indirect loop valvuloplasty plus endovenous laser treatment plus high ligation. RESULTS: Successful occlusion of the varicose veins was noted in all patients after initial treatment. Colour Doppler showed successful occlusion in all greater saphenous vein trunks. Induration in 11 limbs (37.9%) along the course of the treated veins was present, ecchymosis in 2 limbs (6.9%) was noted, and slight burn in 1 limb (3.4%) appeared. During a median follow-up interval of 12 months (ranged from 12 to 36 months), the symptoms of 23 limbs (79.3%) disappeared or alleviated, ulcer in the lower portion of the 11 legs (73.3%) healed, and 2 limbs (6.9%) suffered from light edema and 1 limb (3.4%) from deep venous thrombosis. CONCLUSION: Indirect loop valvuloplasty plus endovenous laser treatment plus high ligation is effective and practical in the treatment of PDVI with such advantages as safety, minimal invasiveness, small scar and fast recovery.