应用股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全的疗效评价

Evaluation of encircling constriction of superficial femoral vein in the treatment of primary deep venous insufficiency

目的用CEAP分类记分法 (clinical,etiologic ,anatomic ,andpathophysiologic ,CEAP)评价股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全 (PDVI)的疗效和应用价值。方法将 97例 (97侧肢体 )经顺行性静脉造影证实PDVI的患者分为A组 79侧 ,B组 18侧。A组行大隐静脉高位结扎剥脱 +交通支结扎术同时行股浅静脉瓣膜环形缩窄术 ,B组仅行大隐静脉高位结扎剥脱+交通支结扎术。以CEAP临床分类与临床记分评价疗效。结果A、B两组术后临床记分均明显下降 (A组由 6 4± 3 7降至 1 7± 1 8,P <0 0 1;B组由 3 8± 3 6降至 1 4± 1 5 ,P <0 0 5 ) ,A组较B组下降程度更大 (P <0 0 1)。结论从CEAP临床记分结果看 ,股浅静脉瓣膜环形缩窄手术有助于PDVI患者临床症状缓解。因此术前明确诊断为PDVI的患者 ,应行股浅静脉瓣膜环形缩窄手术。

Objective To evaluate the effect of encircling constriction of superficial femoral vein in the treatment of primary deep venous insufficiency (PDVI) with CEAP classification and clinical scoring. Methods Ninety-seven limbs in 97 PDVI patients diagnosed by ascending venography were divided into Group A (79 limbs) and Group B (18 limbs). Patients in group A were treated with encircling constriction of venous wall at the first valve of superficial femoral veins added with high ligation and ablation of great saphenous vein, ablation of superficial veins and ligation of perforator veins. Patients in group B were simply treated with high ligation and ablation of great saphenous vein, ablation of superficial veins and ligation of perforator veins. CEAP classification and clinical scoring were proceeded from two months to six years postoperatively to evaluate the effect of the operation. Results The difference between preoperative and postoperative scores in group A and B were both remarkable (in group A: P<0.01; in group B: P<0.05). Scores in group A decreased more significantly (P<0.01). Conclusions Encircling constriction of superficial femoral vein is useful to relieve the symptom of PDVI.