微创技术联合手术治疗下肢静脉功能不全的疗效

Mini-invasive Technique Combined with Surgical Procedure in the Treatment of Chronic Venous Insufficiency of Lower Limbs

目的评价腔内激光灼闭术(EVLT)、光照下动力旋切抽剥曲张静脉术及内窥镜筋膜下交通静脉结扎术(SEPS)等微创技术联合手术治疗下肢静脉功能不全的疗效。方法2002年8月-2004年1月,112例下肢静脉功能不全患者共123条肢体,施行微创技术联合手术治疗。结果患者皮肤曲张静脉消失,手术切口一期愈合,7例足靴区溃疡2-8周内愈合,术后住院天数平均6d。随访2-19月,均恢复良好,无行走障碍,局部无复发。Duplex超声检查,EVLT后残留静脉主干管腔均闭塞,SEPS后交通静脉闭塞。结论微创手术在下肢静脉功能不全疾病的治疗中有极好的应用前景,但其适应证和疗效的评价有待于进一步研究。

Objective To evaluate the efficacy of mini-invasive technique such as endovenous laser treatment (EVLT) , transilluminated powered phlebectomy and subfascial endoscopic perforator surgery (SEPS) combined with surgical procedure in the management of venous insufficiency of lower limbs. Methods From August 2002 to January 2004, 123 legs in 112 patients with venous insufficiency of lower limbs were treated with mini-invasive technique combined with surgical procedure. Results After treatment, the symptoms of varicosity disappeared and incisions were all well healed. Seven ulcers were cured within 2 to 8 weeks. The average postoperative hospital stay was 6 d. After a follow-up of 2 to 19 months, all patients had good results without walking problems and no recurrence occurred. All residual trunk lumens after EVLT and perforators after SEPS were occluded in duplex ultrasonography. Conclusion Mini-invasive technique has been applied very well in the treatment of venous insufficiency of lower limbs. However, it still needed further study on defining indications and evaluate the efficacy of this new technique.