内镜筋膜下超声刀离断交通支静脉治疗下肢静脉性溃疡25例分析

Analysis of 25 cases subfascial endoscopic perforator surgery with ultrasonic scalpel in treatment of venous ulcer of lower extremity

目的：探讨内镜筋膜下超声刀离断交通支静脉治疗下肢静脉性溃疡的安全性、可行性及临床疗效。方法：2002年6月至2009年3月用内镜筋膜下超声刀离断交通支静脉治疗21例共25条下肢静脉性溃疡，观察术前、术后下肢静脉功能改变及临床症状改善情况。结果：下肢活动性溃疡均愈合，平均愈合时间31d；切口均一期愈合；静脉曲张消失，皮肤营养障碍改善；随访4个月～7年无复发。结论：内镜筋膜下超声刀离断交通支静脉治疗下肢静脉性溃疡微创、安全、有效。

Objective：To study the security, feasibility and clinical curative effect of subfaseial endoscopic perforator surgery （SEPS） in treatment of venous ulcer of lower extremity by ultrasonic scalpel. Methods：Twenty-one patients （25 limbs ） who suffered from venous ulcer of lower extremity received SEPS from Jun. 2002 to Mar. 2009. The changes of lower extremity veins function and im- provement of clinical manifestations were studied before and after SEPS. Results：All active venous ulcers were cured, the average healing time was 31 days. All incisions were primarily healed. All varicose veins disappeared and skin nutrition disorders obviously reduced after operation. The postoperative follow-up was 4 months to 7 years, and no limbs suffered from recurrent varicose veins or ulcer. Conclusions：SEPS with ultrasonic scalpel is a mini-invasive, safe and effective method for treatment in venous ulcer in lower, extremity.