血管镜直视下股浅静脉壁外瓣膜修复成形术

Superficial femoral vein valvuloplasty under direct an-gioscopic vision

针对原发性下肢深静脉瓣膜功能不全的病变特点，作者设计并实行了血管镜直视下股浅静脉壁外瓣膜修复成形术。该手术的适应证主要为瓣膜先天发育完善，但受致病因素作用瓣叶发生皱褶脱垂，瓣叶间出现不规则裂隙，瓣环存在不同程度的扩张。此手术的优点主要有：（１）血管镜可以确诊瓣膜功能不全的程度，并直视诊察瓣膜的结构状态，为瓣膜修复成形术提供可靠的依据。（２）此手术避免了切开静脉壁和暴露瓣膜，减少了术后血栓形成的机率。同时由于手术在正常静脉腔截面积视野中进行，术者易于准确把握瓣膜缩缝矫正的程度。（３）本手术克服了Ｋｉｓｔｎｅｒ静脉壁外瓣膜修复成形术的盲目性，变经验性非直视术为直视性修复成形术，可直视诊察瓣叶间裂隙在修复术前后的变化过程。经对１８例成年患者（２０条下肢）临床应用观察，近期疗效良好。

AbstractSuperficial femoral vein valvuloplasty (SFV) un-der direct angioscopic vision without venotomy was de-signed and performed in 18 patients (20 limbs), suffer-ing from primary SFV valve incompetence and the pri-mary popliteal vein valve insufficiency. The indicationof the operation is that the valves developed completelyinborn, but with the effects of postnatal pathogenicfactors,the leaflets prolapsed and became redundant, irregular diastema between leaflets emerged and thevalve-ring dilated. The operation has several advan-tages: (1) Angioscopy confirms primary venous valveincompetence. (2) The technique precludes venotomyand valve exposure, reducing the rate of postoperativevenous thrombosis. (3) The operation eliminates theblindness of kistner's external surgical technique,overcoming its empiricism. The initiai clinic use of thetechnique has shown that it is of excellent short-termeffect without complications.