下肢静脉性溃疡的联合微创治疗

Minimally Invasive Treatment of Venous Ulcers of Lower Limb

目的探讨腔内激光闭合术结合聚桂醇泡沫硬化剂曲张静脉注射、穿静脉结扎治疗下肢静脉性溃疡的疗效。方法下肢静脉性溃疡45例63肢,全部在硬膜外麻醉下行高位结扎大隐静脉主干及其属支,激光闭合大隐静脉主干;泡沫硬化剂栓塞曲张侧枝静脉团块;穿静脉特别是Cockett穿通支点状离断。结果随访3～12个月,所有患肢溃疡全部愈合,均恢复正常生活和工作,无一例复发。结论腔内激光治疗术结合聚桂醇泡沫硬化剂曲张静脉注射、穿静脉结扎治疗下肢静脉性溃疡效果确切,微创伤,恢复快,达到美腿效果。

Objective To explore the curative effects of endovenous laser closure combined with varicose vein injection of lauromacrogol sclerosing foam and perforating vein ligation on ve- nous ulcers of lower limb. Methods Forty-five patients with venous ulcers of lower limb （63 legs） were treated with high ligation of great saphenous vein and its tributaries,laser closure of great saphenous vein, varicose collateral vein injection of lauromaerogol sclerosing foam and Cock- ett perforating vein interruption under epidural anesthesia. Results After 3 to 12 months of fol- low-up,all ulcers healed and all patients returned to normal life and work. No patients had ulcer recurrence. Conclusion The endovenous laser closure combined with varicose vein injection of lauromacrogol sclerosing foam and perforating vein ligation can achieve exact and cosmetic effects and lead to minimal invasiveness and quick recovery in the treatment of venous ulcers of lower limb.