彩色多普勒超声引导下的Müller氏术联合硬化剂治疗下肢静脉曲张371例临床观察

Effect of Müller’s phlebectomy combined with injection of sclerosant guided by colour Doppler ultrasonogrphy on 371 patients with lower-limb varicose veins

目的探讨彩色多普勒超声引导下的Müller氏术联合硬化剂治疗下肢静脉曲张的效果。方法选取2014至2021年371例(448条患肢)下肢静脉曲张患者,利用彩色多普勒超声诊断和定位,采用Müller法行微创手术治疗。结果单纯性隐股静脉瓣功能不全87条,仅合并有交通静脉瓣功能不全261条,同时合并有交通静脉瓣功能不全及腘隐静脉瓣功能不全43条,单纯性交通静脉瓣功能不全12条,单纯腘隐静脉瓣功能不全32条,腘隐静脉瓣功能不全合并交通静脉瓣功能不全13条。术后患者均无明显疼痛,原有溃疡均在术后1个月左右愈合;半年后下肢点状手术瘢痕均已不明显;另18例术前足靴区溃疡合并小腿段硬皮病样改变患者,3个月后局部残留静脉予以硬化剂治疗。结论利用彩色多普勒超声可对下肢静脉曲张准确诊断并精准定位。Müller法微创手术治疗疼痛轻微、神经损伤少、恢复快、美观,疗效确切。

Objective To investigate the effect of Müller phlebectomy combined with injection of sclerosant guided by colour Doppler ultrasonogrphy on lower-limb varicose veins.Methods A total of371 cases(448 limbs)with lower-limb varicose veins were diagnosed and marked by colour Doppler ultrasonogrphy,then treated by müller’s phlebectomy.Results Single saphenous vein valve insufficiency in 87 limbs,accompanying by the insufficiency of perforating veins in 261 limbs,accompanying by popliteal saphenous valve insufficiency and insufficiency of perforating veins in 43 limbs,single insufficiency of perforating veins in 12 limbs;single popliteal saphenous valve insufficiency in 32 limbs,accompanying by the insufficiency of perforating veins in 13 limbs.Scarcely pain appears after operation,ulcers recover within 1 month,scars become unobviously within 6 months;after operation3 months,18 cases with ulcer and scleroderma before operation received sclerotherapy.Conclusions Lower-limb varicose veins can be diagnosed and marked precisely by colour Doppler ultrasonogrphy.Müller’s phlebectomy for lower-limb varicose veins is characterized by mini-invasion,fast-recovery and well curative effects.