下肢深静脉瓣膜反流程度与临床表现相关性调查

The correlation between the lower extremity deep venous reflux degree and clinical symptoms

目的探讨下肢深静脉瓣膜反流程度与临床表现的相关性。方法回顾性收集2006年1月~2012年6月896例原发性慢性下肢静脉功能不全(PCVI)的患者资料,对符合纳入标准的269例患者进行系统抽样调查,根据数字减影血管造影结果及下肢深静脉的反流程度对患者进行Kistener分级,探讨下肢深静脉瓣膜反流程度与临床症状分级(C分级)、临床症状严重程度评分(VCSS)及功能障碍评分(VDS)的相关性。结果下肢深静脉瓣膜反流程度与C分级、VCSS、VDS有相关性(相关系数分别为:0.437、0.505和0.449,P【0.001);穿通支病变对临床症状分级、临床症状严重度、劳动力丧失度有重要影响,并与下肢深静脉反流程度相关(相关系数分别为0.885、0.709、0.845和0.902,P【0.01);伴发疾病、是否处理伴发病及是否穿弹力袜对临床症状分级的影响无统计学意义(P】0.05),是否处理伴发疾病对临床症状严重度及劳动力丧失度有相关性(P【0.05)。结论 PCVI临床症状的严重程度受下肢深静脉瓣膜反流程度及穿通支静脉功能状态的影响,深静脉瓣膜修复对本病的远期疗效及降低复发率方面起着重要作用。

Objective To investigate the correlation between lower extremity deep venous reflux degree and clinical manifestations. Methods From January 2006 to June 2012, the data of 896 patients with primary chronic venous insufficiency (PCVI) were collected retrospectively. Two hundred and sixty-nine patients who met the inclusion criteria received systematic sampling investigations. All cases were made Kistener classification according to the lower extremity deep venous reflux degree observed by digital subtraction angiography (DSA), in order to discuss the correlation among the lower extremity deep venous reflux degree and clinical symptoms classification (C classification), venous clinical severity score (VCSS) and venous disability score(VDS). Results The correlations were statistically significant among the lower extremity deep venous reflux degree and C classification, VCSS and VDS (the correlation coefficients:0.437, 0.505, 0.449, respectively, P<0.01). Perforating venous lesions had important effect on C classification, VCSS and VDS and correlated with the lower extremity deep venous reflux degree significantly(the correlation coefficients:0.885, 0.709, 0.845, 0.902, respectively, P<0.01).Concomitant diseases, the management and whether to wear elastic stockings had no effect on C classification (P>0.05). Whether to manage the concomitant diseases or not related to VCSS and VDS significantly (P<0.05). Conclusion The severity of PCVI clinical symptoms can be affected by the lower extremity deep venous reflux degree and the function of perforating veins. The repair of deep venous valve plays important roles in long-term efficacy and reducing the recurrence rate of PCVI.