中国实用外科杂志

中国实用外科杂志

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下肢静脉剥脱术对节段性深静脉反流影响的前瞻性研究

张    弘，杨    植   

  1. 承德医学院附属医院血管外科，河北承德市067000 
  • 发布日期:2012-02-24

  • Published:2012-02-24

摘要：

目的    探讨下肢浅静脉剥脱术后病人深静脉反流程度的变化。方法    2007年1月至2009年1月承德医学院附属医院血管外科收治下肢静脉曲张合并有节段性深静脉反流的病人46例，对其共48条下肢采用传统手术治疗，超声观察下肢深静脉反流程度，应用临床表现严重程度评分（VCSS）评估临床症状的改善情况。结果    42例病人随访2年，术后2年VCSS为1.95±1.78，低于术前（6.33±1.78），差异具有统计学意义（P<0.01）。2年后超声检查深静脉反流程度无改变肢体22条，改善14条，加重6条，手术前后深静脉反流程度差异无统计学意义。不同CEAP分级的反流程度的改善差异无统计学意义（P=0.359）。结论    浅静脉剥脱术后能改善伴有深静脉反流病人的临床症状，对部分病人可改善深静脉反流程度，改善程度与CEAP分级不相关。

关键词: 静脉功能不全, 外科手术, 下肢, 静脉剥脱术

Abstract:

Impact of stripping of superficial vein in lower extremity on segmental deep venous reflux        ZHANG Hong, YANG Zhi. Department of Vascular Surgery, Affiliated Hospital, Chengde Medical College，Chengde 067000,China
Corresponding author: ZHANG Hong, E-mail:cdzhanghong@gmail.com
Abstract    Objective    To explore effect of stripping of superficial veins in lower extremity on deep venous reflux. Methods    Forty-six patients with 48 lower extremities with combined superficial and deep venous reflux underwent the traditional surgery between January 2007 and January 2009 in the Department of Vascular Surgery, Affiliated Hospital of Chengde Medical College. Venous clinic severity score (VCSS) and color duplex ultrasound test were used to evaluate clinic symptoms and valve reflux of deep veins. Results    Forty-two patients were followed up for 2 years. At two years after surgery, score of VCSS was 1.95±1.78, which was lower than 6.33±1.78 before operation significantly (P<0.01). Deep venous reflux reduced in 14 limbs, progressed in 6 limbs, no change in 22 limbs. Deep venous reflux before and after surgery had no significant differences in the degree.Change of deep venous reflux was not different between different CEAP classification (P=0.359). Conclusion    Superficial vein surgery can relieve symptom of patients with deep venous reflux, and reduce segmental deep venous reflux in part of patients. Change of deep venous reflux is not relative to CEAP classification.

Key words: venous insufficiency, surgery, lower extremity, vein surgery