下肢深静脉血栓形成后综合征的外科治疗

Surgical Treatment on Postthrombotic Syndrome

作者对１７例（男性１２例，女性５例，年龄７～６５岁）下肢深静脉血栓形成后综合征患者的诊断、治疗进行讨论，目的是通过手术方法解除股深静脉、大隐静脉、股静脉开口处闭塞状况，并且为其提供流出道。采用的手术方法有３种：（１）大隐静脉一耻骨上交叉转流术。（２）原位大隐静脉转流术。（３）用带外支持环的人造血管搭桥术。结果为诊治１７例患者，１５例（８８．２％）症状明显缓解，２例症状缓解不满意。通过我们的研究提示对下肢深静脉血栓形成后综合征的患者，经正确的诊断，相应的手术方式，精细的操作，术后抗凝，会取得较满意的治疗效果。可进行推广应用于临床。

rom 1989 to 1993,the authors have treated 17 cases with the postthrombotic syndrome,12males,5 females,age ranging from 7 to 65 years old. Pive were in the right lower limb,twelve inthe left.One had two obstructions in a single leg。Diagnosis and treatment of this disease were discussed. By operation therapy ,the occlusion site indeep femoral vein,saphenous vein or superficial femoral vein should be relieved and an efferent tractshould be provided。 There were three kinds of operations:(1)transpubic cross-over saphenous bypass。(2)In site saphenouspoplitcal vein bypass,(3)Suprasymphysary femoral venular bridge , using vascu-lar prosthesis with external ring. The results showed that, after five- years following up , the symptomof all 17 cases had significant relief,including excellent result in 15 cases(88.2%),failure in 2cases(11. 8%).Authors concluded that a correct diagnosis , pruper operation, careful manipulationand postoperative anticoaulant therapy may be important for a favorate result