腘静脉外袢成形术治疗下肢静脉倒流性疾病的疗效再评价

目的再评估静脉外袢成形术治疗下肢静脉倒流性疾病的疗效。方法将重度下肢深静脉功能不全 (deepvenousinsufficiency ,DVI)患者分为肌袢组 :行静脉外袢成形术加浅静脉手术 (2 8例 2 9条肢体 ) ,浅静脉组 :仅行浅静脉手术 (46例 5 0条肢体 ) ,比较手术效果。结果肌袢组与浅静脉组在手术前后的下肢胀痛、静脉曲张均由 10 0 0 %降至 9 0 %左右 ;小腿肿胀分别由10 0 0 %和 92 0 %下降为 2 0 7%和 2 2 0 % ;术后难愈合的溃疡分别为 6 9%和 0 0 % ;3年内小腿浅静脉曲张复发率分别为 13 8%与 8 0 %。但 2组之间比较 ,差异无显著意义 (均P >0 0 5 )。结论静脉外袢成形术治疗DVI的疗效尚需进一步评价。

Reappraisal of muscular loop substitute valve of popliteal vein in the treatment of reflux venous disorders of the lower extremities

Objective To reappraise the effectiveness of muscular loop substitute of the popliteal vein in the treatment of deep venous insufficiency (DVI) of the lower limbs. Methods Patients with severe DVI were divided into 2 groups. Group A (28 cases, 29 limbs) received muscular loop substitute valve procedures and superficial venous procedures. Group B (46 cases, 50 limbs) simply received superficial venous procedures. Results were compared between the 2 groups. Results The incidence of heaviness and varicosity in both groups decreased from 100.0%(pre-op)to about 9.0%(post-op);Calf swelling decreased from 100.0% to 20.7% in group A,from 92.0% to 22.0% in group B; Unhealing ulcer rate was 6.9% in group A and 0.0% in group B; The recurrency rate of varicosity within 3 years was 13.8% in group A and 8.0% in group B( P >0.05). Conclusion The value of muscular loop substitute valve of the popliteal vein in the treatment of DVI remains to be further evaluated.