股浅静脉戴戒术联合大隐静脉高位结扎剥脱术治疗原发性下肢深静脉瓣膜功能不全的疗效观察

Curative effect observation of encircling constriction of superficial femoral vein combined with high-ligation and stripping for great saphenous vein in the treatment of primary deep venous valve insufficiency

目的观察股浅静脉戴戒术(EC)联合大隐静脉高位结扎剥脱术治疗原发性下肢深静脉瓣膜功能不全(PDVVI)的疗效。方法选择PDVVI患者156例,其中82例(95条患肢)行股浅静脉EC术+大隐静脉高位结扎剥脱术为观察组,74例(84条患肢)行单纯大隐静脉高位结扎剥脱术为对照组,比较两组手术前后彩超检查指标、CEAP分级、临床症状评分及生活质量调查表评分(CIVIQ)变化。结果末次随访时,观察组深静脉平均血流速度较对照组提高更显著(P<0.05),返流持续时间缩短较对照组更显著(P<0.05)。观察组CEAP分级改善明显优于对照组(P<0.05),临床症状评分及CIVIQ评分降低较对照组更显著(P<0.05)。结论股浅静脉EC术联合大隐静脉高位结扎剥脱术PDVVI能够明显改善患肢深静脉血流动力学及瓣膜功能,缓解患者临床症状、体征,提高患者生活质量,疗效优于单纯大隐静脉高位结扎剥脱术。

Objective To observe the curative effect of encircling constriction(EC)of superficial femoral vein combined with high-ligation and stripping for great saphenous vein in the treatment of primary deep venous valve insufficiency(PDVVI).Methods We selected 156 patients with PDVVI for this study.Among them,82 patients(95 affected limbs)undergoing EC of superficial femoral vein and high-ligation and stripping for great saphenous vein were included in the observation group while 74 patients(84 affected limbs)undergoing simple high-ligation and stripping for great saphenous vein were included in the control group.Changes of color Doppler ultrasound indexes,CEAP grade,clinical symptom scores and Chronic Venous Insufficiency Questionnaire(CIVIQ)scores for quality of life were compared before and after operation between the two groups.Rsults At last follow-up,the mean blood flow velocity of deep veins in the observation group was significantly higher than that in the control group(P<0.05),and the duration of reflux was shortened more significantly than the control group(P<0.05).At last follow-up,the improvement of CEAP grade in the observation group was significantly better than that in the control group(P<0.05),and the clinical symptom score and CIVIQ score were significantly lower than those of the control group(P<0.05).Conclusion EC of superficial femoral vein combined with high-ligation and stripping for great saphenous vein for treating PDVVI can significantly improve the deep venous hemodynamics and valve function of affected limbs,relieve the clinical symptoms and signs,and improve the quality of life of the patients.The curative effect is better than simple high-ligation and stripping for great saphenous vein.