内镜在下肢慢性静脉性溃疡治疗中的应用研究

目的探讨内镜在下肢慢性静脉性溃疡治疗中的应用效果。方法应用内镜手术治疗2000年5月-2003年9月收治的26例患者（28条患肢），该28条患肢均同时存在浅静脉倒流、交通支静脉功能不全和慢性静脚性溃疡。经顺行性深静脉造影和彩色多普勒检查显示14条患肢同时存在重度深静脉反流。结果28条患肢经手术治疗后肢体症状和浅静脉曲张消失，患慢性静脉性溃疡肢体短期内愈合。随访13-54个月（平均30．5个月），无新生的溃疡，无静脉曲张复发。结论内镜手术治疗下肢慢性静脉性溃疡安全有效，损伤少，并发症少，如同时联合浅静脉微创刨吸术和血管镜下深静脉瓣膜修复术，可达到更微创和显效的效果。

Study of endoscope in treatment of chronic venous ulcer in lower limb

Objective] To evaluate the role of endoscope in the treatment of chronic venous ulcer in the lower limb. Methods] Between May.2000 and Sep.2003, 26 patients(28 limbs) with surperficial venous reflux and incompetent perforator underwent minimally invasive surgery. Twenty -eight limbs had active ulcers. Fourteen limbs had severe deep venous refluxapp through duplex ultrasonography and deep venography (anterograde). Results] The surgery obviously improved venous disability, varicose vein disappeared in all patients who had undergone minimally invasive operation; ulcers healed shortly in twenty-eight limbs. There had been no ulcer recurrences and recurrent varicoses during follow-up (mean 30.5 months, range 13~54 months). Conclusions] Endoscopic operation is safe and effective as well as less harm and complication in the treatment of chronic venous ulcer in the lower limb. More minimally invasive operation and better result are expected when combined with minimally invasive operation of the varicose and external valvuloplasty of the superficial femoral vein with angioscopy.