彩色多普勒超声引导无切口皮下缝扎大隐静脉治疗大隐静脉曲张

Ultrasound Guided Surgery Without Incision for Varicosis of Great Saphenous Veins

目的：探讨彩色多普勒超声引导下，无切口大隐静脉曲张手术的临床疗效。方法2011年12月～2013年12月，30例（37条患肢）单纯性大隐静脉曲张在彩色多普勒超声定位、引导下行大隐静脉主干高位皮下缝扎、分支曲张静脉及交通支静脉皮下缝扎。结果手术无切口。单侧手术时间17～42 min，中位时间28 min。术后住院2～5 d，中位时间3 d。30例（37条患肢）术后随访3～21个月，平均13．2月，无下肢疼痛，下肢迂曲、曲张静脉消失，溃疡愈合，色素沉着减轻，彩超检查大隐静脉主干闭合良好，无血流信号，深静脉通.，无血栓形成，2例局部复发，采用局麻，彩超精确定位、引导下皮下缝扎处理，治愈。结论彩色多普勒超声定位、引导下行大隐静脉主干高位皮下缝扎、分支曲张静脉及交通支静脉皮下缝扎疗效确切，无切口，美观，值得推广。

Objective To investigate the therapeutic effects of ultrasound guided surgery without incision in the treatment of great saphenous varicose veins . Methods Ultrasound guided surgery without incision was performed in 30 cases of varicose great saphenous veins （37 limbs） from December 2011 to December 2013.Under the guidance of ultrasonography , the great saphenous vein stem, branch, and communicating branch were intracutaneously suture ligated respectively . Results All the operation were performed without incision .The operation time was 17-42 min （ median, 28 min） .Postoperative hospital stay ranged from 2 to 5 days （median, 3 days）.All the patients were followed up for 3-21 months with a mean of 13.2 months.The symptoms of the 30 cases after the surgery relieved significantly .The local skin malnutrition atrophy was relieved gradually and the venous varicosis disappeared completely.There were 2 cases of recurrence , who were cured by ultrasound guided intracutaneous suture ligation of communicating branch under local anesthesia . Conclusion Ultrasound guided surgery without incision is a safe , effective , and minimally invasive procedure for great saphenous varicose veins , being worthy of recommendation .