经皮穿刺大隐静脉下肢静脉造影术的临床应用

目的 探讨经皮穿刺大隐静脉下肢静脉造影术(PGSV)对髂静脉病变和下肢深静脉瓣膜功能检查的可行性和临床应用价值.资料与方法 78例(86条患肢)经皮穿刺大隐静脉注入对比剂进行髂静脉病变和下肢深静脉瓣膜功能的检查,并与经皮穿刺足背浅静脉下肢静脉造影术(PDPV)进行比较.结果 PGSV 的第1、2和3次静脉穿刺成功率分别为36.36%(20/55)、43.64%(24/55)和20.0%(11/55).PGSV对髂静脉的清晰显示明显优于PDPV(P＜0.05).与PGSV相比,PDPV诊断髂静脉受压综合征、股浅静脉第一对瓣膜和隐股静脉瓣膜功能不全的敏感性分别为11.76%、46.67%和59.65%.结论 经皮穿刺大隐静脉下肢静脉造影术具有操作简单、损伤小,可部分替代经皮穿刺股静脉造影术对髂静脉病变和部分下肢深静脉瓣膜功能的检查.

Application of Venography of Lower Extremity Via a Percutaneous Great Saphenous Vein Access

Objective To investigate the feasibility of the percutaneous great saphenous venography (PGSV) in the lower extremity in the detection of iliac venous diseases and deep venous valve function of lower extremity. Materials and Methods PGSV was performed in 78 cases to evaluate iliac venous diseases and deep venous valve function of lower extremity and compared with the precutaneous dorsal pedal venography (PDPV). Results The success rate of PGSV for the first, second and third time was 36.36%(20/55), 43.64%(24/55) and 20.0%(11/55), respectively. PGSV showed the iliac vein better than PDPV (P<0.05). Compared with PGSV, sensitivity of PDPV in the examination of the iliac vein compression syndrome, the venous valve dysfunction of the first valve of superficial femoral vein, and sapheno-femoral junction was 11.67%, 46.67% and 59.65%, respectively. Conclusion PGSV could be a convenient micro-invasive method and replace phlebography via the femoral access in the detection of iliac venous diseases and partial deep venous valve function of lower extremity.