• 新疆維吾爾自治區(qū)人民醫(yī)院血管外科 (烏魯木齊 830001);

目的 觀察下肢淺靜脈手術(shù)改善深靜脈瓣膜功能的中期隨訪結(jié)果。
方法 收集2006年3～10月期間在我院行手術(shù)治療的下肢靜脈曲張患者43例(55條肢體)，全部患者曾在術(shù)后半年進(jìn)行隨訪并比較了手術(shù)前、后深靜脈瓣膜功能改善情況，術(shù)后4年再次以同樣方法評(píng)價(jià)其深靜脈瓣膜功能改善情況。
結(jié)果 39例患者深靜脈瓣膜功能保持良好，與術(shù)后半年隨訪時(shí)無(wú)明顯差異。4例當(dāng)時(shí)未行高位結(jié)扎的患者，再次出現(xiàn)淺靜脈曲張，且深靜脈存在返流。
結(jié)論 伴有深靜脈瓣膜功能不全的下肢淺靜脈曲張，單純行淺靜脈激光閉合術(shù)或剝脫術(shù)均可有效改善深靜脈瓣膜功能，且效果保持良好; 高位結(jié)扎大隱靜脈是保證改善深靜脈瓣膜功能的關(guān)鍵。

引用本文： 戈小虎,任昊,李雪松,賽力木. 下肢淺靜脈手術(shù)后深靜脈瓣膜功能變化的中期結(jié)果報(bào)道. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(7): 649-652. doi: 復(fù)制

1. ColeridgeSmith PD. Leg ulcer treatment [J]. J Vasc Surg, 2009; 49(3): 804808.
2. Wang SM, Hu ZJ, Li SQ, et al. Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity [J]. J Vasc Surg, 2006; 44(6): 12961300.
3. Dunn CW, Kabnick LS, Merchant RF, et al. Endovascular radiofrequency obliteration using 90 degrees C for treatment of great saphenous vein [J]. Ann Vasc Surg, 2006; 20(5): 625629.
4. Mizaushev BA, Kosenkov AN, Aslanov AD, et al. Surgical treatment of patients with chronic lower limb venous insufficiency and trophic disorders [J]. Khirurgiia (Mosk), 2005; (10): 2427.
5. Qiao T, Liu C, Ran F. The impact of gastrocnemius muscle cell changes in chronic venous insufficiency [J]. Eur J Vasc Endovasc Surg, 2005; 30(4): 430436.
6. Tawes RL, Barron ML, Coello AA, et al. Optimal therapy for advanced chronic venous insufficiency [J]. J Vasc Surg, 2003; 37(3): 545551.
7. Lfgren KA. Surgical management of chronic venous insufficiency [J]. Acta Chir Scand Suppl, 1988; 544: 6268.
8. 任昊, 戈小虎, 劉杰, 等. 下肢淺靜脈手術(shù)后深靜脈瓣膜功能的變化 [J]. 國(guó)際外科學(xué)雜志, 2007; 34(12): 809812.
9. Kistner RL. Primary venous valve incompetence of the leg [J]. Am J Surg, 1980; 140(2): 218224.
10. Rosales A, Slagsvold CE, Kroese AJ, et al. External venous valve plasty (EVVP) in patients with primary chronic venous insufficiency (PCVI) [J]. Eur J Vasc Endovasc Surg, 2006; 32(5): 570576.
11. Lane RJ, Cuzzilla ML, McMahon CG. Intermediate to longterm results of repairing incompetent multiple deep venous valves using external valvular stenting [J]. ANZ J Surg, 2003; 73(5): 267274.
12. Perrin M, Hiltbrand B, Bayon JM. Results of valvuloplasty in patients presenting deep venous insufficiency and recurring ulceration [J]. Ann Vasc Surg, 1999; 13(5): 524532.
13. Dunn RM, Fudem GM, Walton RL, et al. Free flap valvular transplantation for refractory venous ulceration [J]. J Vasc Surg, 1994; 19(3): 525531.
14. Cheatle TR, Perrin M. Venous valve repair: early results in fiftytwo cases [J]. J Vasc Surg, 1994; 19(3): 404413.
15. 王志剛, 雷澤華, 余慎林. 靜脈腔內(nèi)激光和傳統(tǒng)手術(shù)治療下肢靜脈曲張的近期療效比較 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010; 17(4): 372375.
16. 楊國(guó)凱, 楊鏞, 何曉明, 等. 射頻閉合聯(lián)合動(dòng)力旋切治療下肢靜脈曲張 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(1): 6063.
17. 陳開, 劉崇清, 戴毅, 等. 應(yīng)用微創(chuàng)刨吸術(shù)治療下肢靜脈曲張52例報(bào)告 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(5): 515516.
18. Bergan JJ. Venous insufficiency and perforating veins [J]. Br J Surg, 1998; 85(6): 721722.
19. Zamboni P, Cisno C, Marchetti F, et al. Reflux elimination without any ablation or disconnection of the saphenous vein. A haemodynamic model for venous surgery [J]. Eur J Vasc Endovasc Surg, 2001; 21(4): 361369.
20. Walsh JC, Bergan JJ, Beeman S, et al. Femoral venous reflux abolished by greater saphenous vein stripping [J]. Ann Vasc Surg, 1994; 8(6): 566570.
21. Puggioni A, Lurie F, Kistner RL, et al. How often is deep venous reflux eliminated after saphenous vein ablation? [J]. J Vasc Surg, 2003; 38(3): 517521.
22. Walsh JC, Bergan JJ, Beeman S, et al. Femoral venous reflux abolished by greater saphenous vein stripping [J]. Ann Vasc Surg, 1994; 8(6): 566570.
23. Sales CM, Bilof ML, Petrillo KA, et al. Correction of lower extremity venous incompetence by ablation of superficial venous reflux [J]. Ann Vasc Surg, 1996; 10(2): 186189.
24. Ting AC, Cheng SW, Wu LL, et al. Changes in venous hemodynamics after superficial vein surgery for mixed superficial and deep venous insufficiency [J]. World J Surg, 2001; 25(2): 122125.
25. 任昊, 戈小虎, 劉杰, 等. 下肢靜脈曲張行淺靜脈手術(shù)對(duì)深靜脈瓣膜功能影響的研究 [J]. 中國(guó)普通外科雜志, 2008; 17(12): 12111216.
26. 王磊, 侯寶忠, 于威, 等. 外科治療原發(fā)性下肢靜脈曲張 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(5): 605607.
27. 祿韶英, 祁光裕, 孫學(xué)軍, 等. 血管腔內(nèi)激光治療下肢淺靜脈曲張的初步觀察 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11(5): 1.
  1. 1. ColeridgeSmith PD. Leg ulcer treatment [J]. J Vasc Surg, 2009; 49(3): 804808.
  2. 2. Wang SM, Hu ZJ, Li SQ, et al. Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity [J]. J Vasc Surg, 2006; 44(6): 12961300.
  3. 3. Dunn CW, Kabnick LS, Merchant RF, et al. Endovascular radiofrequency obliteration using 90 degrees C for treatment of great saphenous vein [J]. Ann Vasc Surg, 2006; 20(5): 625629.
  4. 4. Mizaushev BA, Kosenkov AN, Aslanov AD, et al. Surgical treatment of patients with chronic lower limb venous insufficiency and trophic disorders [J]. Khirurgiia (Mosk), 2005; (10): 2427.
  5. 5. Qiao T, Liu C, Ran F. The impact of gastrocnemius muscle cell changes in chronic venous insufficiency [J]. Eur J Vasc Endovasc Surg, 2005; 30(4): 430436.
  6. 6. Tawes RL, Barron ML, Coello AA, et al. Optimal therapy for advanced chronic venous insufficiency [J]. J Vasc Surg, 2003; 37(3): 545551.
  7. 7. Lfgren KA. Surgical management of chronic venous insufficiency [J]. Acta Chir Scand Suppl, 1988; 544: 6268.
  8. 8. 任昊, 戈小虎, 劉杰, 等. 下肢淺靜脈手術(shù)后深靜脈瓣膜功能的變化 [J]. 國(guó)際外科學(xué)雜志, 2007; 34(12): 809812.
  9. 9. Kistner RL. Primary venous valve incompetence of the leg [J]. Am J Surg, 1980; 140(2): 218224.
  10. 10. Rosales A, Slagsvold CE, Kroese AJ, et al. External venous valve plasty (EVVP) in patients with primary chronic venous insufficiency (PCVI) [J]. Eur J Vasc Endovasc Surg, 2006; 32(5): 570576.
  11. 11. Lane RJ, Cuzzilla ML, McMahon CG. Intermediate to longterm results of repairing incompetent multiple deep venous valves using external valvular stenting [J]. ANZ J Surg, 2003; 73(5): 267274.
  12. 12. Perrin M, Hiltbrand B, Bayon JM. Results of valvuloplasty in patients presenting deep venous insufficiency and recurring ulceration [J]. Ann Vasc Surg, 1999; 13(5): 524532.
  13. 13. Dunn RM, Fudem GM, Walton RL, et al. Free flap valvular transplantation for refractory venous ulceration [J]. J Vasc Surg, 1994; 19(3): 525531.
  14. 14. Cheatle TR, Perrin M. Venous valve repair: early results in fiftytwo cases [J]. J Vasc Surg, 1994; 19(3): 404413.
  15. 15. 王志剛, 雷澤華, 余慎林. 靜脈腔內(nèi)激光和傳統(tǒng)手術(shù)治療下肢靜脈曲張的近期療效比較 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010; 17(4): 372375.
  16. 16. 楊國(guó)凱, 楊鏞, 何曉明, 等. 射頻閉合聯(lián)合動(dòng)力旋切治療下肢靜脈曲張 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(1): 6063.
  17. 17. 陳開, 劉崇清, 戴毅, 等. 應(yīng)用微創(chuàng)刨吸術(shù)治療下肢靜脈曲張52例報(bào)告 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(5): 515516.
  18. 18. Bergan JJ. Venous insufficiency and perforating veins [J]. Br J Surg, 1998; 85(6): 721722.
  19. 19. Zamboni P, Cisno C, Marchetti F, et al. Reflux elimination without any ablation or disconnection of the saphenous vein. A haemodynamic model for venous surgery [J]. Eur J Vasc Endovasc Surg, 2001; 21(4): 361369.
  20. 20. Walsh JC, Bergan JJ, Beeman S, et al. Femoral venous reflux abolished by greater saphenous vein stripping [J]. Ann Vasc Surg, 1994; 8(6): 566570.
  21. 21. Puggioni A, Lurie F, Kistner RL, et al. How often is deep venous reflux eliminated after saphenous vein ablation? [J]. J Vasc Surg, 2003; 38(3): 517521.
  22. 22. Walsh JC, Bergan JJ, Beeman S, et al. Femoral venous reflux abolished by greater saphenous vein stripping [J]. Ann Vasc Surg, 1994; 8(6): 566570.
  23. 23. Sales CM, Bilof ML, Petrillo KA, et al. Correction of lower extremity venous incompetence by ablation of superficial venous reflux [J]. Ann Vasc Surg, 1996; 10(2): 186189.
  24. 24. Ting AC, Cheng SW, Wu LL, et al. Changes in venous hemodynamics after superficial vein surgery for mixed superficial and deep venous insufficiency [J]. World J Surg, 2001; 25(2): 122125.
  25. 25. 任昊, 戈小虎, 劉杰, 等. 下肢靜脈曲張行淺靜脈手術(shù)對(duì)深靜脈瓣膜功能影響的研究 [J]. 中國(guó)普通外科雜志, 2008; 17(12): 12111216.
  26. 26. 王磊, 侯寶忠, 于威, 等. 外科治療原發(fā)性下肢靜脈曲張 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007; 14(5): 605607.
  27. 27. 祿韶英, 祁光裕, 孫學(xué)軍, 等. 血管腔內(nèi)激光治療下肢淺靜脈曲張的初步觀察 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004; 11(5): 1.