下肢深静脉功能不全诊治的实验与临床研究

Deep venous incompetence of legs: experimental studies

目的寻找下肢深静脉瓣膜包窄术最佳环包材料，了解彩超对深静脉瓣膜功能不全的诊断价值和静脉瓣膜功能。方法（１）观察３０条实验犬以自体大隐静脉片、自体阔筋膜和人造血管片作深静脉瓣膜包窄术的效果；（２）对７８例彩超与经静脉插管造影结果对比；（３）观察正常人与患者静脉瓣膜血液动力学变化。结果自体阔筋膜和大隐静脉逐渐挛缩呈纤维化瘢痕增生，而膨体聚四氟乙烯人造血管的形态和结构无明显变化；彩超检查与经静脉插管造影比较准确率为９１８６％；屏气时股静脉瓣膜同时关闭，小腿三头肌收缩时静脉瓣膜开放程度显著大于股静脉瓣膜。结论以膨体聚四氟乙烯人造血管作环包材料效果最好；彩超以其无创性成为重要的检测手段；

Objective To seek best wrapping materials of valvular wrapping operation of deep veins in the lower limbs and to understand the value of diagnostic value of duplex scanning for incompetence of the deep veins and the function of the popliteal valve. Methods Strips of the autogenous saphenous vein,autogenous fascia lata and PEFE graft were used respectively as the material for valve constriction. The results were compared of duplex scanning and transpopliteal venography. Results In the saphenous vein and fascia lata groups, diffuse fibrosis and marked narrowing of the femoral vein were found,whereas in the vascular graft group the graft was intact without prominent fibrosis and narrowing of the vein. The accurate rates of duplex scanning and transpoplital venography were 91 86%. at the same time the thigh and popliteal valve was closed when held breath. Conclusions Vascular graft is the best constriction material. Duplex scanning is a important method. Popliteal valve is an important barrier for protecting the function of the deep rein.