内镜下交通静脉离断联合手术治疗下肢静脉性溃疡

目的内镜下交通支离断术subfascial endoscopic perforator vein surgery（SEPS）联合手术治疗下肢静脉性溃疡76例的疗效观察。方法下肢静脉性溃疡患者76例,共82条患肢。按不同病因分为3组,采用SEPS＋相应手术方法治疗：A组：中、重度原发性下肢深静脉瓣膜功能不全39条患肢,行SEPS＋大隐静脉高位结扎术＋腔内激光（endovenous laser treatment EVLT）＋股浅静脉瓣膜包窄术;B组：轻度原发性深静脉瓣膜功能不全24条患肢,行SEPS＋大隐静脉高位结扎＋EVLT;C组：高位结扎＋抽剥术溃疡复发者19条患肢,行SEPS＋EVLT。结果术后患肢症状和浅静脉曲张消失。76例患肢溃疡在术后14-60天内全部愈合。结论SEPS联合手术具有微创、安全、并发症少的特点,治疗下肢静脉性溃疡疗效满意。

Effect of subfascial endoscopic perforator vein surgery (SEPS) with operation in treatment of patients with venous ulceration of the leg

Aim To evaluate the effect of subfaseial endoscopic perforator vein surgery （SEPS） with operation in treatment of patients with venous ulceration of the leg. Methods 76 patients with varicose vein of lower limbs with a total of 82 lower limbs underwent SEPS with concomitant surgery. Three therapeutic entities were included ： group A, moderate and severe primary valvular incompetence （39 limbs） ：SEPS combined with external banding valvuloplasty of superficial femoral vein and high ligation and stripping of varicose vein; group B, mild primary valvular incompetence （24 limbs） ：SEPS combined with EVLT; group C, The ulcerations were recurred on patients who had ligation and stripping of varicose vein （ 19 limbs） ： SEPS combined with EVLT. Results All symptoms and varicose veins disappeared after SEPS. Ulcers healed in 14 to 60 clays in 76 patients, ulcers reduced in size markedly in another 2 cases. Conclusion Subfascial endoscopic perforator vein surgery for venous ulcers of limbs is minimally invasive, and safe with complications a satisfactory result.