大/小隐静脉主干分段结扎+属支Muller术治疗下肢浅静脉曲张疗效分析

Effect of combined stepwise GSV/CSV ligation with muller's phlebectomy on superficial varicosis of lower limbs

[目的]探讨准确标记和抽剥器引导下大／小隐静脉（great／smallsaphenousvein，GSV／SSV）主干分段结扎＋属支muller术治疗下肢浅静脉曲张的价值。[方法]术前准确标记和术中抽剥器静脉内引导下，65例（72个肢体）C3～6级下肢浅静脉曲张患者行GSV或GSV／SSV分段结扎＋属支Muller术，比较临床表现严重程度评分（venousclinicalseverityscore，VCSS）术前术后变化。[结果]术后10例（11条患肢）一过性肿胀，1例切口感染，1例胫前残留曲张静脉属支，1例小腿压迫性溃疡，均经对症处理后缓解。和术前相比较，术后90d的VCSS明显下降（7．0±4．2VS1．5±0．5，t=2．25，P≤0．05）。[结论]准确标记和抽剥器引导下分段结扎＋属支Muller术治疗CVI，既可做到微创美观，又可保证手术的彻底性.

[ Objective] To investigate tbe therapeutic value of combined stepwise ligation of the great/small saphenous vein （GSV/CSV） guided by accurate marking and inversion stripping with muller＇s phlebectomy for superficial varicosis of lower limbs. [ Methods] There were 65 cases （72 lower limbs）, among whom 61 limbs of GSV and 11 limbs of GSV/SSV were stepwisely ligated guided with accurate marking and inversion stripping, and all varicose branches were treated with muller hook. Venous clinical severity score （VCSS） were analyzed retrospectively. [ Results ] After operation, there were 10 cases （11 limbs） that experienced temporary, swelling, 1 case of incision infection, 1 case of residual varicosis and 1 case of compressive ulcer. All of them recovered after expectant treatment. The value of VCSS （ 1.5 ± 0.3 ） in 90 days after operation decreased significantly （ t = 2. 25, P 〈0.05 ） when comparing with that （7.0 ±4.2 ） before operation. [ Conclusions ] Stepwise ligation of GSV/CSV guided by accurate marking and inversion stripping with muller＇ s phlebectomy is microinvasive, esthetic and thorough to treat superficial varieosis of lower limbs.