腔内激光联合手术处理浅静脉曲张治疗下肢深静脉瓣膜功能不全的疗效评价

Endovascular laser therapy combined with high ligation of varicose veins in treatment of deep venous insufficiency

目的 评价腔内激光联合大隐静脉高位结扎处理浅静脉曲张治疗下肢深静脉瓣膜功能不全的疗效.方法 下肢慢性静脉功能不全患者64例75条下肢,深静脉瓣膜反流时间＞0.5s且≤1.5s者纳入轻度反流组,深静脉瓣膜反流时间＞1.5s者纳入重度反流组.两组患者采用静脉腔内激光治疗联合大隐静脉高位结扎为主的浅静脉处理,术后4～6个月随访,对比术前、术后患者的深静脉瓣膜反流时间及临床分期.结果就深静脉瓣膜反流时间而言,术后轻度反流组较重度反流组治愈率明显升高,差异有统计学意义（P＜0.05）.所有患者临床症状评分均明显下降,两组间差异无统计学意义（P ＞0.05）.结论 对于深静脉瓣膜轻度反流者,行腔内激光处理浅静脉为主的手术即能较好的改善深静脉反流.对于深静脉重度反流者应加行深静脉瓣膜重建手术.

Objective To evaluate the clinical results of endovascular laser therapy （EVLT） combined with high ligation of varicose veins in treatment of deep venous insufficiency. Methods Total 75 limbs of 64 patients which were divided into two groups： mild reflux group （n=40, 0.5s〈RT≤ 1.5s） and severe reflux group （n=35, RT〉1.5s） according deep veins valve reflux time （RT）. Two groups of patients were treated with EVLT combined with high ligation of the great saphenous vein. All the limbs were examined with color Doppler ultrasonography for reflux time of the first valve and open case on 4 - 6 months after treatment. Results The mild reflux group had higher cure rate than the severe reflux group （P〈0.05）.All patients clinical symptom scores were obviously decreased, between two groups hadn＇t statistically significant （P〉 0.05）. Conclusion For patients with mild deep venous reflux endovenous laser therapy with high ligation of superficial vein can effectively reduce the deep venous reflux.