下肢深静脉功能不全的检测与修复材料选择的研究

目的寻找下肢深静脉瓣膜包窄术最佳环包材料，了解彩色超声多普勒对深静脉瓣膜功能不全的诊断价值和月国静脉瓣膜功能。方法观察以自体大隐静脉片、自体阔筋膜和人造血管片作深静脉瓣膜包窄术的效果；彩色超声多普勒与经月国静脉插管造影结果对比；月国静脉瓣膜血液动力学检查。结果自体阔筋膜和大隐静脉片逐渐挛缩呈纤维化瘢痕增生，而人造血管的形态和结构无明显变化；彩色超声多普勒与经月国静脉插管造影检测下肢深静脉功能比较，前者与后者的符合率为９１．８６％；屏气时股、月国静脉瓣膜同时关闭，小腿三头肌收缩时月国静脉瓣膜开放程度明显大于股静脉瓣膜。结论以人造血管作环包材料效果最好；彩色超声多普勒以其无创性成为重要的检测手段；月国静脉瓣膜是保护小腿深静脉功能的最后屏障

EXPERIMENTAL STUDY OF INCOMPETENCY OF DEEP VEIN OF LOWER LIMB

OBJECTIVE: The purpose of this study was to find the best material for valvular wrapping operation of deep vein of lower limb and to study the diagnostic value of colored Ultrasonic-Doppler for valvular incompetency of the deep vein and the function of the popliteal valve. METHODS: Strips of autogenous saphenous vein, autogenous fascia lata and pieces of polytetrafluroethylene artificial vessel were used respectively as the wrapping material for narrowing the valve in 30 dogs. The results of three different wrapping material were obtained by colored Ultrasonic-Doppler and transpopliteal venography in 78 patients. The hemokinetics of the popliteal valve was examined in 20 normal persons. RESULTS: In the saphenous vein and fascia lata groups, diffuse fibrosis and marked narrowing of the femoral vein were found, while in the group of artificial vein graft, the graft was intact without prominent fibrosis and narrowing of the vein. In comparing with the result of venography, the accuracy of diagnosis by colored Ultrasonic-Doppler was 91.86%. The femoral and popliteal venous valves closed at the same time when holding the breath, but the popliteal venous valve opened more widely than the femoral venous valve when the calf muscles of the leg contracted. CONCLUSION: It was suggested that the graft was the best material for valvular wrapping operation, and colored Ultrasonic-Doppler was an important and non-invasive method for the diagnosis of incompetency of deep vein. The popliteal venous valve was the important barrier for protection of the function of deep vein.