瓣膜重建术治疗下肢原发性深静脉瓣膜功能不全

Valvular Reconstruction in Treatment of Primary Incompetence of Deep Vein Valve in Lower Extremity

以下肢浅静脉曲张、足踝部色素沉着和溃疡形成为特征的下肢原发性深静脉瓣膜功能不全是外科常见病。手术治疗需分二期进行,第一期采用国静脉外肌袢形成术或股浅静脉外瓣膜包窄术;第二期于二周后,再作患肢大隐静脉剥脱术与交通静脉结扎术。近二年间,我院用本法治疗此病共100例,计107条下肢,术后随访81例,取得满意疗效。本文讨论了此病的病理变化手术的作用和适应证。

Primary incompetence of deep vein valve in lower extremity characterized by varicosity,pigmnet deposition and ulcer formation of the leg is a common surgical disease. The treatment should be carried out in two stages of operations. The first stage operation adopts either the formation of a substitute valve in the form of a tendon loop at the popliteal vein,or moderate constriction of superficial femoral vein at the main valve region with a segment of great saphenous vein, cut ted longitudinally and wrapped horizontally. The second stage operation is performed two weeks later. If a substitute valve is established in the first stage, a high ligation of great saphenous vein, ligation and stripping of varieosed veins in the leg and ligation of communicating veins were carried out. If a moderate constriction of superficial femoral vein is instituted in the first stage, no high ligation of the great saphenous vein is necessary to be done, while ligation and strip of the varicosed veins in the leg and ligation of communicating veins are still necessary. During the period from Feb 1989 to Dec 1990 the authors adopted this scheme of treatment in 100 patients,including 107 limbs. 81 patients were followed up after operation. The results were satisfactory. The pathological changes and the role and indications of the operation were discussed.