静脉曲张术后深静脉内径及功能变化的研究进展

Changes of deep vein diameter and function after varicose vein operation

原发性下肢静脉曲张是由于血液由深静脉向浅静脉反流而引起的。高压反流的血液通过反流点远心端的一支或多支穿静脉回流入深静脉,从而形成了“深静脉-浅静脉-穿静脉-深静脉”之间的无效循环。进入该循环的血液增加了穿静脉及深静脉的血流负荷,导致二者扩张,继而可能出现功能不全,此即为“超载理论”。而不同类型的静脉曲张手术,若能有效阻断这一病理性“深静脉-浅静脉-穿静脉-深静脉”之间的循环,减少大量反流血液重新通过穿静脉进入深静脉,即对穿静脉及深静脉存在保护作用,并可能会改善穿静脉及深静脉功能。既往研究揭示了下肢静脉回流时不同水平深静脉、浅静脉内压力的变化规律,以及浅静脉反流及浅静脉反流阻断后穿静脉及深静脉的形态及功能变化情况。本文通过广泛查阅国内外关于下肢静脉曲张与深静脉功能及静脉曲张术后深静脉变化相关研究的文献,对下肢静脉曲张术后深静脉内径及功能变化情况进行综述。

Primary varicose vein of the lower extremity is caused by blood reflux from the deep vein to the superficial vein.The blood with high pressure reflux flows back into the deep vein through one or more perforating veins at the distal of the reflux point,thus forming an ineffective circulation between"deep vein-superficial vein-perforating vein-deep vein".The blood entering this circulation increases the blood flow load of the perforating veins and deep veins,leading to dilation of them,and then may lead to insufficiency.This is called"overload theory".However,if surgery of varicose vein can effectively block the pathological"deep vein-superficial vein-perforating vein-deep vein"circulation and reduce the amount of reflux blood re-entering to the deep vein through the perforating vein,it can protect the perforating vein and deep vein,and may improve the function of the perforating vein and deep vein.Previous studies have revealed the changes of deep and superficial venous pressure at different levels during lower extremity venous reflux,as well as the morphological and functional changes of penetrating and deep vein after superficial venous reflux and occlusion of superficial venous reflux.In this paper,the internal diameter and functional changes of deep vein after varicose vein operation of lower extremity were reviewed and analyzed by extensively reviewing domestic and foreign literature on the relationship between varicose vein of lower extremity and deep vein function and deep vein changes after varicose vein operation.