小腿交通支功能不全在下肢慢性静脉功能不全临床表现中的意义

Role of incompetence of the calf perforating veins in the clinical manifestations of chronic venous insufficiency in the lower extremities

目的：探讨小腿内侧功能不全的交通支在下肢慢性静脉功能不全临床表现中的意义。方法：106例慢性静脉功能不全患者的126条肢体接受检查。利用顺行性静脉造影术检查小腿交通支功能；依据临床、病因、解剖、病理的分类(CEAP classification)将临床表现作临床分级，用Kendall等级相关分析分别分析小腿内侧功能不全的交通支数目、直径与临床分级之间相互关系。结果：1. 126条肢体中共发现小腿功能不全的交通支402条，其中分布于内侧有307条(76.37%)，分布于后侧和外侧有95条(23.63%)。 2. 小腿内侧功能不全的交通支的数目和直径的增加与慢性静脉功能不全的临床分级的增加均呈正相关。结论：下肢慢性静脉功能不全的皮肤改变好发于内踝区域与小腿功能不全的交通支多分布于小腿内侧及其中下段有关。对小腿内侧交通支功能不全的治疗对改善下肢慢性静脉功能不全的临床表现尤其是皮肤改变具有重要意义。

Objective: This study was undertaken to investigate the role of incompetence of the calf perforating veins in the clinical manifestations of chronic venous insufficiency (CVI) in the lower extremities. Methods: 106 patients with 126 limbs of CVI were examined. Perforator function of the calf were detected by ascending venography. And also, the clinical manifestations of CVI were classified in class by the standard of CEAP classification (the clinical, etiologic, anatomic and pathophysiologic classification). Kendall's rank correlation analysis was applied among the numbers, diameters of incompetent perforating veins (IPVs), and the clinical class of CVI. Results: 402 IPVs were identified in 126 limbs, 307 IPVs (76.37%) were located in the medial calf, and another 95 IPVs (23.63%) were found in the posterior, anterolateral of the calf.The numbers, diameters of the medial calf IPVs shown positive correlation with the clinical class of CVI. Conclusions: The skin changes of CVI in the lower extremities are mainly relevant to the prevelence of the IPVs in the lower medial calf. The treatment of the IPVs in the medial calf may take some advantages to improve the clinical manifestations, especially skin changes.