腘静脉肌袢松解术预防深静脉血栓形成的临床观察(附19例报道)

Muscular loop release for "substitute valve" operation in preventing deep venous thrombosis:a clinical observation of 19 cases

目的探讨腘静脉外肌袢松解术预防深静脉血栓形成的临床意义。方法上海交通大学医学院附属第九人民医院血管外科于2000年1月—2008年12月为19例曾因下肢深静脉瓣膜功能不全行腘静脉外肌袢形成术,术后3～11年再次出现下肢慢性静脉不全,并经下肢静脉顺行造影诊断为肌袢粘连的患者行肌袢松解术。结果无1例死亡。所有患者均未发生严重并发症,下肢浅静脉曲张消失,肿胀缓解。7例慢性湿疹患者痊愈。16例患者接受随访,随访时间为6～120个月,平均随访时间为(56±10)个月。彩色多普勒超声检查均未发现深静脉血栓形成。结论慎重选择腘静脉外肌袢形成术治疗下肢深静脉瓣膜功能不全,并密切随访已手术患者。对肌袢粘连患者建议行腘静脉肌袢松解术以预防血栓形成。

Objective To study the value of muscular loop release for ＂substitute valve＂ operation in preventing deep venous thrombosis. Methods Totally 19 patients with recurrent chronic venous insufficiency of lower extremities, who underwent ＂substitute valve＂ operation 3- 11 years ago, were reviewed retrospectively. Adhesion of muscular loop was confirmed by ascending venography and all patients were re-operated by muscular loop release. Results No death occurred and there were no severe complications. The clinical manifestations of patients were obviously improved and the healing of ulcer was observed in all patients after operation. And 84.2 % patients （16/19） were followed-up for a mean of （56±10） of months （6-120 months）. Duplex Scanning found no complications such as deep venous thrombosis. Conclusion Candidate of ＂substitute valve＂ operation should be selected cautiously to avoid early and late complications after operation. Muscular loop release in patients with ＂substitute valve＂ operation can prevent deep venous thrombosis.