SEPS治疗重度非溃疡性下肢静脉功能不全的临床疗效

Clinical analysis of Subfascial Endoscopic Perforator Vein Surgery in treatment of lower limb chronic venous insufficiency(C4,C5)

目的探讨腔镜深筋膜下交通静脉离断术(SEPS)治疗重度非溃疡性下肢静脉功能不全(CVI)的临床疗效。方法回顾性分析2012年11月-2013年7月新疆克拉玛依市中心医院应用SEPS治疗20例(28条患肢)C4、C5级CVI患者的临床资料。患者均行大隐静脉高位结扎+SEPS。观察患者术后临床症状体征的改善情况。结果所有患者手术顺利。术后患者独立下床活动时间平均为19.3h,术后平均住院日为3.2d。术后出现皮肤坏死1例,皮下血肿2例,隐神经损伤1例。术后肢体酸胀感和曲张浅静脉消失,色素沉着区缩小。后期随访期间未发现静脉曲张复发,也未发现溃疡发生或复发。静脉曲张、酸胀、水肿、疼痛、皮炎等症状体征改善较为明显,色素沉着改善欠佳,静脉临床表现严重程度评分(VCSS评分)明显下降。结论 SEPS是治疗C4、C5级CVI患者的良好选择,具有创伤小、出血少、恢复快、并发症少等特点。

Objective To evaluate the clinical experiences and treatment effectiveness of serious chronic ve-nous insufficiency without venous ulcer in lower limb .Methods From November 2012 to July 2013 in our hospital ,twenty patients （twenty-eight limbs） suffering lower limb chronic venous insufficiency （C4 ,C5） were analyzed retrospectively .All the patients had undergone high ligation for great saphenous vein plus subfascial endoscopic perforator vein surgery （SEPS） .Results All patients proceeded successfully .The mean ambulation time was 19 3. hours ,and the mean duration of hospitalization was 3 2. d in postoperation . Postoperative complications included 1 cases of skin necrosis ,2 cases of subcutaneous hematoma ,1 cases of saphenous nerve injury .The surgery obviously ameliorated sore and heavy feeling ,varicose veins and lo-cal pigmentation .There was no recurrence of varicose ,without ulcer recurrence and new ulcers formation in follow-up period .Conclusion SEPS is a good alternative for CVI （C4 ,C5） .It has less invasiveness , lower chances for bleeding ,quicker recovery ,and fewer complications .