腔内激光联合手术治疗下肢静脉曲张的实验和临床研究

目的评价改进腔内激光(EVLT)联合手术治疗下肢静脉曲张的疗效。方法下肢静脉曲张90例116条下肢。按病因和病情采用3种手术治疗(1)A组临床表现明显的原发性下肢深静脉瓣膜功能不全24条下肢,作股浅静脉瓣膜包窄 大隐静脉高位结扎 EVLT 内镜下小腿内侧交通静脉离断术SEPS;(2)B组轻度原发性深静脉瓣膜功能不全26条下肢,作大隐静脉高位结扎 EVLT SEPS;(3)C组单纯性大隐静脉曲张66条下肢,作大隐静脉高位结扎 EVLT。结果平均随访20个月,3组患者均无复发,临床症状和体征消退或好转,溃疡均愈合。彩超检查示大隐静脉全程闭合,无血流信号,深静脉回流通畅。结论EVLT具有微创、安全、操作简单和疗效良好的优点,针对病因和病情联合不同手术治疗下肢静脉病变效果满意。

Experimental and clinical studies on EVLT combined with operation for venous varicosis of lower limbs

Objective:To evaluate the results of EVLT in combination with surgery and technical improvements in treating venous disease of lower limbs.Methods:90 patients with a total of 116 disease lower limbs underwent EVLT with concomitant surgery,Three therapeutic entities were included:(1)severe primary reflux of the deep veins 24 limbs:EVLT external banding valvuloplasty of superficial femoral vein high-ligation at the saphenofemoral junction SEPS,(2)mild primary reflux of the deep veins 26 limbs:EVLT high-ligation of saphonofemoral junction SEPS,(3)Simple saphenous varicosity 66 limbs:EVLT high-ligation of great saphenous vein.Results:All patients were followed up with a mean of 20 months with satisfactory outcomes.Conclusion:EVLT in combination with surgery is a new therapeutic entity possessing advantages of safety,easy-performance,minimal invasiveness and good results.