血管内电凝瓣膜修复治疗下肢深静脉瓣膜功能不全的手术探讨

目的探讨股部小切口修复静脉瓣膜、血管内电凝曲张静脉治疗原发性下肢深静脉瓣膜功能不全的微创手术方法。方法选择67例原发性下肢深静脉瓣膜功能不全的病人,在硬膜外麻醉或腰麻下取股部小切口,行第一对股浅静脉瓣膜外修复,同时利用40 W手术电刀对迂曲扩张的浅静脉进行血管内电凝。总结手术入路和手术体会。结果患者术后7 d拆线,股部小切口愈合良好,下肢曲张浅静脉消失,无淋巴漏等并发症发生;随访1~5年,超声多普勒检查电凝后的大隐静脉和曲张浅静脉均已闭合,无曲张静脉复发现象,但有2例瓣膜修复处术后3年有轻度返流。结论股部小切口修复瓣膜结合血管内电凝曲张静脉,是一种较好的治疗下肢深静脉瓣膜功能不全的微创手术方法,操作简便、创伤小、恢复快、并发症少,值得推广应用。

Operative Investigation of the Integrated Mini-trauma Venous Valve Repairing and Intravenous Electrocoagulation for Primary Deep Venous Valve Dysfunction in Lower Limbs

Objective To investigate a new mini-trauma operative method of primary deep venous valve dysfunction with integrated vale repairing and intravenous electrocoagulation.Method The integrated mini-trauma vale repairing and intravenous electrocoagulation operation were performed through small femoral incision under the epidural anesthesia or lumbar anesthesia in 67 patients,and the operative approaches and operative experiences were summarized.Results All patients were cured without any complication.No recurrence was found during 1 to 5 years' following-up,otherwise back flow was found in 2 cases.Conclusion The integration of electrocoagulation and valve repair operation with small incision is a convenient,aesthetic and mini-traumatic therapy for the patients with primary deep venous valve dysfunction,which's worthy to be widespread used.