股浅静脉瓣窦环包术治疗原发性股静脉瓣膜关闭不全

Treatment of primary femoral venous valular incompetence by encircling wrapping venous valvular sinus

自1987年2月至1989年1月,应用大隐静脉壁环包股浅静脉第一对瓣膜关闭不全的瓣膜窦治疗原发性下肢深静脉瓣膜关闭不全16例(17个肢)取得满意效果。方法是:大隐静脉高位结扎,游离出股浅静脉第一对瓣膜,将切下的大隐静脉纵行剖开,拼缝成与股静脉瓣窦大小相似的静脉片,其下缘缝于瓣环线上,缝线结扎后以指压法无血液逆流为度。大隐静脉片前缘缝合,其上缘固定于股静脉壁上,常规作小腿曲张静脉及交通支结扎。随访1～23个月,三周后可去除外支持恢复正常工作,溃疡愈合,症状消失,我们认为这一手术是较为合理的方法。

From February 1987 to January 1989, 16 cases (17 limbs) of primary femoral venous valvular incompetemce were treated by encircling wrapping first pair of superficial femoral venousvalvular sinus. Method of operation consists of: saphenous vein was Iigated, exposing the first valves of the superficial femoral vein, cutting the harvested saphenous vein in-to one or two, or three segments, the length of them being just same as the venous sinus, which were wrapped, and putting two or three of them together, sutured side by side. Then the venous pi(?)ce encircling wrapping was done with a suture just below the valve and was hastened to a vein 0.1—0.2cm smaller than the original spasmodic femoral vein. Function of valve was tested by pressure. If it is normal, the edges of the venous piece are sutured and wrapped around the whole valvular sinus. The superficial varicose veins, and all the perforating veins, external or under the deep fasia of the lower leg were stripped. This operation did not injure venous wall and valves, and did not require anticoagulant therapy postoperatively. Postoperative follow-up study for 1—23 months demonstrated that all limbs do not need external support three weeks later and patients can return to normal work. The signs over the limbs disappear, and ulcers have not recurred. As compared with other procedures reported in literatures, the results showed that this operation seems to be reasonable (or the treatment of primary femoral venous valvular incompetence.