大隐静脉术后出现下肢肿胀和复发的原因分析

目的:探讨大隐静脉术后出现下肢肿胀和复发的原因。方法:总结我院从2006年9月~2008年2月下肢静脉曲张术后复发病人的临床资料。所有病人患肢均行浅深静脉和交通静脉彩色多普勒超声检查和深静脉顺行造影。结果:合并大隐静脉主干及其部分属支残存11条肢体,合并深静脉瓣膜功能不全16条肢体,合并交通静脉功能不全26条肢体,合并深静脉血栓后遗症6条肢体,合并Cocket综合征2条肢体,合并淋巴瘤2例。结论:下肢静脉曲张术后复发的原因较为复杂,通常累及3个静脉系统。交通静脉和深静脉瓣膜功能不全是术后复发的主要原因。术前行彩色多普勒超声检查和患肢深静脉顺行造影,选择合理的手术方式是避免术后复发的关键。

Causes of recurrence of great saphenous vein after varicotomy in lower extremity

Objective:To explore the causes of recurrence and swelling of great saphenous vein after varicotomy in lower extremities.Methods: The data were gathered from Sept.2006 to Feb.2008 and a total of 28 patients(39 lower extremities)with the recurrence of varicose veins after varicotomy were analyzed retrospectively.All patients received ascending phlebograph and color Doppler ultrasonography for superficial and perforating veins.Results: The causes of recurrence were due to remnant of the main trunk and partial branches of great saphenous vein(16 limbs),complication of insufficiency of deep venous valves(16 limbs)or insufficiency of perforating veins(26 limbs),sequelae after deep venous thrombosis(6 limbs),Cocket syndrome(2 limbs)or leucoma(2 limbs) Conclusion :Many causes are responsible for the recurrence of varicose veins after varicotomy in lower extremities since three venous systems are involved,but insufficiency of perforating veins and deep valves are the leading ones resulting in the recurrence.Comprehensive pre-operative image examination and right choice of operation may lead to less recurrence of this disease.