下肢深静脉瓣膜功能不全的临床分型及手术方式探讨

The Probe about the Oinical Styles and Operation Methods of Primary Lower Extremity Deep Vein Value Insufficiency

目的 为探讨原发性下肢深静脉瓣膜功能不全(PDVI)不同类型的手术治疗效果。方法 Ⅰa患者采用大隐静脉高位结扎及剥脱术。Ⅰ患者除行大隐静脉高位结扎及剥脱外,需结扎筋膜下瓣膜功能不全的深浅静脉交通支,Ⅱa及Ⅲa患者采用大隐静脉高位结扎及剥脱术,Ⅱb患者采用肢浅静脉外瓣膜修补带戒术,Ⅲb及Ⅳ患者采用改良性(?)静外肌襻成形术。结果随访1-11年,全部患者下肢溃疡完全愈合,静脉曲张未见复发。结论不同PDVI分型病人对选择有效的治疗方法至关重要,并且是取得术后良好远期疗效的关键。

Objective To probe about the operation's curative effect of different kinds of primary lower extremity deep vein value insufficiency (PDVI). Methods To I ?patients, the saphenous veins need to be ligatured at high position on exfoliated, except that, all the insufficient vein branches under fascia of the I patients need to be ligatured. To IIb and IIIa patients, the sapenous vein needs to be ligatured at high position or exfoliated, To IIb patients, insufficient values need to be replaced from the limb shallow veins. To HI b and IV patients, insufficient values need to be ameliorated and taken shape methods. Results After 1 ~ 11 years,all patients' leg ulcers heal up wholly,and their varices were not recur. Conclusion The choices of efficient threap methods were very important for different kinds of (PDVI) patients. And they were the key of obtaining farther more curative effect after operations.