小腿交通静脉功能不全与慢性静脉功能不全相关性的研究

Relationship between incompetent perforator vein and chronic venous insufficiency

目的探讨交通静脉功能不全(IPV)中功能不全交通静脉的分布及其在慢性静脉功能不全(CVI)过程中的角色。方法 46例确诊为CVI患者,临床症状:有坠胀感35例,无坠胀感11例,伴有皮肤瘙痒24例,无皮肤瘙痒22例,有夜间抽筋症状6例,无夜间抽筋40例。46例患者(46条肢体)CEAP分期:C2(19例)、C3(6例)、C4a(11例)、C4b(5例)、C5(3例)、C6(2例)。用多普勒超声定位IPV,测量交通静脉到足底的距离,以大、小隐静脉主干进行内外分区,将小腿分为三段、共八个区段进行记录,数据进行统计分析。结果共记录305个功能不全交通静脉,其中大隐静脉内上(19个)、大隐静脉内中(62个)、大隐静脉内下(34个)、小隐静脉外上(17个)、小隐静脉外中(52个)、小隐静脉外下(6个)、大隐静脉主干(64个)、小隐静脉主干(51个)。小隐静脉外上区段的交通静脉与抽筋,小隐静脉外中区段的交通静脉与CEAP-C分期、皮肤瘙痒,大隐静脉主干区段的交通静脉与抽筋间的关系具有统计学意义(P≤0.05)。结论功能不全交通静脉主要分布于小腿中段及大小隐静脉主干,且与CVI的临床症状相关。

Objective To discuss distribution of incompetent perforator veins (IPV) and the role of IVP in chronic venous insufficiency (CVI). Methods Forty-six patients diagnosed CVI were recruited. Vascular malformations were clinically stratified for CVI according to the CEAP system and underwent incompetent perforator veins with Doppler ultrasonography. The clinical distribution of 46 examined limbs were C2(19 cases)、C3(6 cases)、C4a(11 cases)、C4b(5 cases)、C5(3 cases)、C6(2 cases), feeling of swelling (35 cases), pruritus(24 cases), no pruritus(22 cases), night cramp(6 cases), no night cramp(40 cases). The lengths from sites of IPV to the heel were measured. Medial and lateral partition were divided with the great saphenous veins(GSV)and small saphenous veins(SSV). Three parts were divided in calf. The data were recorded in 8 partitions and analyzed with SPSS software. Results Total 305 IPVs were distributed in GSV medial superior (19),GSV medial middle(62),GSV medial inferior(34),SSV lateral superior(17),SSV lateral middle(52), SSV lateral inferior(6), GSV trunk(64), SSV trunk(51). The differences of IPVs in SSV lateral superior part and cramp , SSV lateral middle and CEAP-C , SSV lateral middle and pruritus, GSV trunk and cramp were statistically significant(P ≤ 0.05) . Conclusion The IPVs are mainly distributed in middle calf, GSV and SSV,and IPVs are correlated with the severity of CVI.