腘静脉瓣膜的形态特点及其临床意义

Morphological characteristics of popliteal venous valves and its clinical significance

目的:为临床诊断和治疗原发性下肢深静脉瓣膜功能不全和构建组织工程静脉瓣膜提供形态学基础。方法:将26例52侧成人腘静脉标本等分为远侧、中间、近侧1/3段,在手术显微镜下解剖和观察,用数控游标卡尺(精度0.01mm)测量瓣膜相关数据,并对瓣膜进行Masson三色改良染色和H-E染色,以观察腘静脉瓣的组织构造。结果:腘静脉瓣膜数为(2.04±1.31)个,瓣膜游离缘主要为半月形(97.2%)。瓣膜以双叶瓣为主(97.2%),其近侧1/3段和中1/3段以前后侧瓣为主(P<0.05)。瓣膜的腔面和窦面均覆着一层内皮细胞,其管腔面内皮细胞下存在数层弹力纤维,瓣膜主要由胶原纤维构成。结论:本文提供的腘静脉瓣的形态特征和数据将有助于临床腘静脉瓣膜相关疾病的诊治和构建组织工程静脉瓣。

Objective： To provide morphological evidences for treating primary lower extremity deep vein valve insufficiency （PDVI） and constructing tissue engineering venous valve. Methods： 52 specimens of the popliteal veins were dissected into three parts equally. The features of each part were observed and the venous leaflets were measured by sliding caliper （0.01 mm）. And then, the valves were H-E and trichrome stained and observed. Results： For each popliteal vein, the average number of venous valves was 2.04±1.31. The free edge of leaflet mainly were crescent-shaped （97.2%）. The frequency of double leaflets was about 97.2% of 52 specimens. There were more anteroposterior valves in the proximal and middle sections compared to that of distal section（P〈0.05）. In histology, the valval surface was covered a wrap of endothelial cells. The lumina surface under the endothelial cells consisted of elastic fibers, and the main component of valves were collagen fibers. Conclusion： The morphological characters of popliteal venous valves are helpful to diagnose and treat the venous diseases, and construct tissue engineering venous valves.