下肢静脉曲张伴小腿慢性溃疡的综合疗法

THE COMPREHENSIVE TREATMENT OF VARICOSIS OF LOWER EXTREMITY WITH CHRONIC ULCER OF LEG

为解决高龄患者的下肢静脉曲张伴小腿大面积慢性溃疡的治疗难题，１９９３年１０月～１９９５年１２月，采用月国静脉肌袢成形术、浅静脉抽出结扎术、溃疡面扩创植皮等综合方法，对１９例溃疡面积大，病程长，年龄大的静脉曲张性小腿慢性溃疡患者进行治疗。术后溃疡全部愈合。随访１年～３年，溃疡及静脉曲张无复发，未发生并发症。认为，对难治性高龄患者的下肢静脉曲张伴小腿大面积慢性溃疡，采用综合治疗措施，可促进静脉回流，改善皮肤血循环，有利于炎症吸收及溃疡愈合。

From Oct. 1993 to Dec. 1995, nineteen refractory cases with varicosis and chronic ulcer of lower limb were treated. The average age of these patients was sixtyeight, the disease history was more than 20 years. The size of the ulcer of the leg ranged from the minimum of 10 cm×8 cm to the maximum of 30 cm×15 cm. All of them had once received saphenectomy and split skin graft without ulcer healing before they were admitted in our department. Both venography and ultrasonography showed superficial venous valve incompetence. The following comprehensive treatment was adopted. Firstly, myoplasty around popliteal vein was done. Secondly, phlebexairesis and phleborrhaphy were done for the variciform veins through minor incision. Then thorough debridement of the ulcer was performed. Delayed split skin graft was exerted one week later. The result showed that all the cases were successful: the ulcer was healed and there was no recurrence of varicosis.