原发性下肢深静脉瓣膜功能不全手术方法的选择

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1、KKME---专业医学搜索引擎http://www.kkme.net/原发性下肢深静脉瓣膜功能不全手术方法的选择　　作者：陈辉，张方，王天佑，陈学明，许晓航，陈福森　　【摘要】目的观察不同手术方法治疗原发性下肢深静脉瓣膜功能不全的疗效。方法150例(240条肢体)经顺行静脉造影证实为原发性下肢深静脉瓣膜功能不全的患者分为A、B、C3组，每组80条患肢。A组行股浅静脉瓣膜外戴戒术，B组行股浅静脉瓣膜外修补术，C组行静脉半腱肌-股二头肌肌襻代瓣膜术，3组均同时行大隐静脉高位结扎剥脱术加交通支结扎术。以CEAP临床分级与临床记分评价疗效。结果3组术后临床记分呈不同程度下降：A组

2、中C2～C4者手术效果较好;B组中C2～C5者手术效果较好;C组中C2～C6者手术效果较好;A、B、C3组手术效果比较，对C2～C4者，3组无明显差异;对C5者，B、C组无明显差异，但A组效果较差;对C6者，C组效果较好，但A、B组效果较差。结论原发性股浅静脉瓣膜功能不全的手术治疗，应依据深静脉瓣膜功能不全的程度决定手术方式。　　【关键词】原发性股浅静脉瓣膜功能不全;瓣膜外戴戒术;瓣膜外修补术;静脉半腱肌-股二头肌肌襻代瓣膜术　　Theselectionforoperationmethodintreatmentofprimarydeepvenousinsufficienc

3、y　　CHENHui,ZHANGFang,WANGTian-You,etal.DepartmentofCardiovascularThoracicSurgery,TheFirstHospital,FangshanDistrict,Beijing102400,ChinaKKME---专业医学搜索引擎http://www.kkme.net/　　【Abstract】ObjectiveToobservethetherapeuticeffectofdifferentoperationmethodsinthetreatmentofprimarydeepvenousinsufficie

4、ncy(PDVI).MethodsTwohundredandfortylowerlimbsinonehundredandfiftypatientswhowereprovedtobePDVIbyascendingvenographyweredividedintoGroupA(80limbs),GroupB(80limbs)andGroupC(80limbs).PatientsofGroupAweretreatedwiththeencirclingconstrictionofvenouswallatthefirstvalveofsuperficialfemoralveins.

5、PatientsofGroupBweretreatedwiththesurgicalrepairoutsidetheincompetentvalveofsuperficialfemoralveins.PatientsofGroupCweretreatedwiththesemitendinosus-bicepsfemorissubstitutevalveoperationoutsidethepoplitealvein.Andtheywerealsotreatedwiththehighligationandablationofgreatsaphenousvein,ablati

6、onofsuperficialveinsandligationofperforatorveinsatthesametime.AscendingCEAPclassificationandclinicalscoringwereproceededfromtwomonthstosixyearsafteroperationtoevaluatetheeffectoftheoperation.ResultsThedifferencebetweenpreoperativeandpostoperativescoresofGroupA,GroupBandGroupCwereremarkabl

7、e(GroupA,P<0.01;GroupB,P<0.01;GroupC,P<0.01).ToC2～C4,therewerenoapparentdifferenceamongthreegroups.ToC5,thetherapeuticeffectofGroupAwasbad.ToC6,thetherapeuticeffectofGroupCwasfairlygood.ConclusionTheselectionforoperationmethodinthetreatmentofPDVIshouldbebasedondegre