腘静脉外肌袢形成术并发症再探讨

目的　对腘静脉外肌袢形成术后并发症作再度探讨。 方法　将１９８１ 年至１９９７ 年１２月内手术的１ ２８４ 例患者，共１６３２ 条下肢中，发生并发症的患肢１５１ 条，根据临床表现、患肢静脉和淋巴造影检查、多功能周围血管检测仪和动态压力测定等的资料，作全面的临床分析，找出并发症的原因，并提出防治的措施。 结果　早期并发症（ 术后６ 个月以内） 以小腿肿胀和深静脉血栓形成为主，在１２８ 条患肢中各为１８ 条（１１－９％） 和９１ 条（６０－３％ ）；２３ 条患肢发生远期并发症（ 术后６ 个月以上） ，以肌袢过短、粘连（１５ 条，９－９％ ）和腘静脉血栓形成（８ 条，５－３％ ） 为主。 结论　肌袢术后并发症多因适应证和手术操作不当，以及手术本身的某些缺陷而引起。熟练、正规的手术操作和选择良好的肌袢替代物，是提高肌袢术疗效的关键

A restudy on complications of substitute valve operation

Objective To evaluate the complications of substitute valve operation for severe deep venous insufficiency of the lower limbs. Methods Complications occurred in 151 lower limbs out of 1 284 patients with a total of 1 632 limbs operated on from 1981 to 1997 were studied. The clinical features, venography, lymphography, personal vascular lab and venous pressure measured were assessed to find out the causes of the complications and their prevention and management. Results The major early postoperative complications were swelling and deep venous thrombosis, while the late ones were caused by the inadequate length or adhesion of the muscular loop and popliteal thrombosis. Conclusions Careful selection of the candidates, proper surgical technique and good substitute of the muscular loop are the keys for satisfactory result.