瓣膜包窄术治疗中重度原发性下肢深静脉瓣膜功能不全

Venous External Valvuloplasty in the Treatment of Moderate or Severe Primary Incompetent Deep Venous Valve of Lower Limbs

目的 对瓣膜包窄术治疗中重度原发性下肢深静脉膜功能不全进行评估。方法 对 5 4例中重度原发性下肢深静脉瓣膜功能不全患者进行下肢深静脉顺逆行造影 ,提示倒流程度均为 2～ 4级 ,通过分析 ,将其分为两大类 :一类是深静脉显著增粗但瓣膜瓣叶的游离缘并未严重受损 ;另一类是瓣膜瓣叶的游离缘严重受损 ,并对第一类深静脉显著增粗但瓣膜瓣叶的游离缘并未严重受损 32例进行瓣膜包窄术。结果 疗效良好 2 9例占90 6 % ,好转者 3例占 9 4 % ,全部患者症状消失 ,溃疡愈合 ,多普勒超声示静脉无明显血液倒流。结论 对原发性下肢深静脉瓣膜功能不全的患者 ,只要瓣膜瓣叶并未严重受损 ,不论其倒流程度如何 ,都可采用瓣膜包窄术。

Objective To evaluate the effectiveness of venous external valvuloplasty in treatmeant of moderate or severe incompetent deep venous valve.Methods 54 patients with moderate and severe primary incompetent deep venous valve underwent anterograde and retrograde venous angiography of lower limbs, the angiography showed that reflux degree were 2～4grade. 54 patients were divided into two groups.The first group patients(n=32) without serious injured free margin of venous valve leaves were treated by venous external valvuloplasty,the other group patients with serious injured free margin of valve leaves(n=22),were other treatment.Results The showed excellent curative effect,were obtained better effect 29(90.6%) of the 32 cases were 3(9.4%) of 32 cases.The symptoms of all patients were disappearance and ulcer were close up. The colour Doppler ultrasonography had shown that blood was not flow backwards in the vein.Conclusions The authors believe that the good results may be expected in the opration of venous external valvuloplasty in patients with moderate and severe primary incompetent deep venous valve whose free margin of valve leaves were not serious injured .