Palma—Dale手术治疗髂静脉闭塞症

目的:探讨单侧髂静脉闭塞的外科治疗.方法:1986～1998年,采用Palma-Dale手术治疗单侧髂静脉闭塞症患者共10例.结果:7例(7/10)获得长期随访,平均随访85个月.术后患肢肿胀、胀痛明显改善,静脉性跛行消失.3例溃疡复发(3/5),其中2例经植皮和游离背阔肌皮瓣移植后溃疡愈合.结论:Palma-Dale手术宜慎重且合理地选择病例.Palma-Dale手术应在患肢闭塞段远侧深静脉主干瓣膜和肌肉泵功能尚未被破坏之前施行;在主干静脉瓣膜已被破坏时,宜考虑同时作瓣膜重建术.

Treatment of Iliac Vein Occlusion by the Palma-Dale's Procedure

Objective: To evaluate the effects of Palma-Dale's operation in treatment of iliac vein occlusion. Methods: Ten consecutive patients were operated on for unilateral iliac vein occlusion from 1986 to 1998. Results: Seven patients were followed up, the mean follow-up period was 85 months. Venous claudication disappeared and chronic lower extremity swelling ameliorated in all seven. Ulceration of the lower extremity recurred in 3 of 5 cases. Conclusions: Careful selection of candidates for Palma-Dale's procedure is the key-point satisfactory results. The operation must be performed early before the venous valve and muscle pump disfunction occur. Valvular reconstruction should be considered for those with deep venous incompetence.