下肢静脉性溃疡的微创治疗

Minimally invasive surgical treatment for venous leg ulcer

目的研究和评价静脉腔内激光联合腔镜深筋膜下结扎交通静脉(SEPS)治疗下肢静脉性溃疡的临床疗效.方法10例下肢静脉性溃疡患者共10条患肢行静脉腔内激光联合SEPS术,对深静脉瓣膜功能不全伴Ⅲ.返流的4条肢体联合行股浅静脉瓣膜外修复成形术.结果10条患肢溃疡在10～60 d内愈合,所有病人随访6月以上未发现局部溃疡复发.结论静脉腔内激光联合SEPS术可以微创、有效地治疗下肢静脉性溃疡,联合股浅静脉瓣膜外修复成形术可以减少下肢静脉性溃疡的复发.

Objective To evaluate therapeutic effects of endovenous laser treatment （ELT） and subfascial endoscopic perforator surgery （SEPS） in the treatment of venous leg ulcer （VLU）. Methods ELT and SEPS were performed in 10 patients with VLU （involving 10 legs）. Among them, extemal valvuloplasty was performed in 4 legs with deep venous valve insufficiency. Results Ulcer of the 10 legs healed within 10-60 days after the operation, and follow-up study ranging from 2 to 8 months with the average of 6 months revealed no recurrences. Conclusion ELT combined with SEPS provides an effective approach for VLU treatment with minimal invasion, and when combined with external valvuloplasty, this approach may effectively reduce ulcer recurrence.