彩色多普勒超声在大隐静脉曲张腔内激光治疗中的应用

目的：探讨二维超声及彩色多普勒血流显像（CDFI）技术在大隐静脉曲张腔内激光治疗术前诊断及术后疗效中的应用价值。方法：术前对306例患者的462条大隐静脉曲张下肢的髂静脉、股深静脉、股浅静脉、静脉和大隐静脉行二维及彩色多普勒超声检查,观察有无深静脉血栓,做Valsalva试验或远端小腿挤压试验检测深静脉瓣膜功能,术后复查大隐静脉闭合情况。结果：462条患肢中,下肢深静脉未见明显返流、深静脉瓣功能正常者31条（6.7%）;深静脉瓣功能不全431条（93.3%）,其中Ⅰ级96条（20.8%）,Ⅱ级123条（26.6%）,Ⅲ级143条（30.9%）,Ⅳ级69条（14.9%）;发生深静脉血栓13例（2.8%）。对其中380条适合手术治疗的病例,行大隐静脉曲张腔内激光手术治疗,术后14天、30天复查,大隐静脉基本闭合,总疗效达100%。结论：彩色多普勒超声能够直观观察大隐静脉情况,方便快捷、无创的评价下肢深静脉瓣膜功能病变程度,检测静脉血栓的位置、范围。对术前诊断、手术病例选择及术后疗效观察具有较高价值。

Application of color Doppler ultrasound on endovenous laser treatment for great saphanous varicose

Objective： To evaluate the application of two dimensional uhrasonography and CDFI in the endovenous laser treatment （EVLT） for the great saphanous varicose, both in the diagnosis and selecting proper cases before operation and the effect evaluation after it. Methods： Before operation, 462 lower extremity veins of 306 patients with great saphanons varicose were chosen. Uhrasound were used to observe if there was thrombus or vaharlar insufficiency in deep vein. Venous valvular function was tested by Valsalva test or by pressing the legs. After operation, file closure phenomenon of great saphanous vein were tested. Results：31 cases （6.7%） had normal deep venous function, others lind deep venous insufficiency, including 96 cases （20.8%） in venous valxadar reflux degree Ⅰ , 123 cases （26.6%） in degree Ⅱ, 143 cases （30.9%） in degree Ⅲ, 69 cases （14.9%） in degree Ⅳ. 13 cases of decp venous thrombus were detected. Among all cases, 380 cases fitted for the operation and were detected 14 days and 30 days after operation, the great saphenons veins were almost closed. The total validity was 100%. Conclusion： Color Doppler ultrasound can be used to observe great saphanous vein directly and repeatedly, for deep venous insufficiency degree in lower extremities non-invasively, detect the position and range of thrombus, therefore, plays an important role in clinical diagnosis, operation choice before operation and effect after operation.