24例下肢静脉性溃疡的外科综合治疗疗效观察

Therapeutic effect of comprehensive surgical management in venous ulcer of lower extremity of 24 cases

目的 探讨下肢静脉溃疡的外科综合治疗效果.方法 对24例由下肢原发性静脉返流性疾病所致下肢静脉溃疡采取综合治疗,包括下肢浅静脉腔内激光治疗术、股浅静脉瓣膜环形缩窄术和腔镜深筋膜下交通支静脉结扎术,对比观察患者术前、术后临床症状和体征.结果 本组24例30条患肢均获随访.术后下肢浅静脉曲张全部消失,足靴区色素沉着明显改善,小腿水肿消退.肢体溃疡于术后22～65天愈合.术后3个月内下肢酸胀感全部消失.结论 外科综合治疗是下肢静脉溃疡较好的手术选择.

Objective To evaluate the effect of the comprehensive surgical management on venous ulcer of lower extremity. Methods Comprehensive surgical management were performed on 24 patients （30 limbs） of venous ulcer of lower extremity in primary venous reflux disease. All limbs were performed with endovenous laser treatment, encircling constriction of superficial femoral vein and subfascial endoscopic perforator vein surgery. The changes of symptoms and signs were recorded and compared before and after operation. Results All the patients were followed up, all varicose veins were gone, and the pigmentation, swelling and edema of leg were improved. Ulcer healed within 22-65 days. Conclusion Comprehensive surgical management is an ideal method in the treatment of venous ulcer of lower extremity.