小腿深筋膜下内镜交通支离断术治疗下肢慢性静脉功能不全

Subfascial endoscopic perforating veins ablation in treating chronic venous insufficiency of lower extremities

目的 探讨小腿深筋膜下内镜交通支离断术 (离断术 )治疗下肢慢性静脉功能不全合并小腿交通支功能不全的疗效。方法 回顾性分析采用离断术治疗 18例 (2 0条肢体 )合并小腿交通支功能不全的下肢慢性静脉功能不全的临床资料。结果 共发现 69条交通支 :功能不全者 62支 ,功能正常者 7支。手术离断 65支 ,遗漏 4支。除色素沉着外 ,手术后临床评分较术前均有明显降低 (P <0 .0 1)。无严重并发症发生 ,术后 3个月随访 ,溃疡愈合率为 88.9% ,愈合后无溃疡复发。结论 小腿深筋膜下内镜交通支离断术是一种新的安全、有效的治疗下肢慢性静脉功能不全合并小腿交通支功能不全的手术方法 。

Objective To evaluate the effect of subfascial endoscopic perforating veins ablation in treating chronic venous insufficiency of lower extremities. Methods A retrospective study was carried out on 18 patients( 20 limbs) with chronic venous insufficiency treated by subfascial endoscopic perforating veins ablation. Results 69 perforating veins were detected in the medial calf of 20 limbs,including 62 incompetent perforating veins and 7 competent perorating veins. 65 perforating veins were ligated but 4 were not found.Apart from the clinical score of pigmentation, there were sigificant decreases in all the mean scores postoperatively (P<0.01). After 3 months follow up, ulcers of 19 limbs healed (88.9%) and none recurred. Conclusions Subfascial endoscopic perforating veins ablation in treating chronic venous insufficiency combined with incompetent calf perforating veins in the lower extremities is safe, effective,and feasible methed.It sufficiently improves the clinical symptoms and signs in chronic venous insufficiency with the lower complications rate, especially suitable for the patients with the venous ulceration resulted from incompetent perforating veins.