临床研究(Clinical Research)

下肢浅静脉曲张手术对深静脉瓣膜功能影响的临床研究

Published at: 2015年第24卷第6期

邱天 1 , 郭曙光 1 , 方伟 1 , 周兴立 1 , 彭明生 1 , 尹存平 1 , 张鹏 1 , 苏宏斌 1 , 张铠 1
1 成都军区昆明总医院 血管外科,云南 昆明 650032
通讯作者 天 邱 Email: 15327510@qq.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.06.017
基金:

摘要

目的:探讨原发性下肢深静脉瓣膜功能不全(PDVI)患者行下肢浅静脉曲张手术对深静脉瓣膜功能的影响。方法:回顾性分析94 例行下肢浅静脉曲张手术的PDVI 患者(95 条肢体)资料,比较患者手术前后深静脉瓣膜功能的变化。结果:术前经彩色多普勒超声检查明确95 条肢体均存在PDVI,按CEAP 分级,C2 级31 条、C3 级22 条、C4 级25 条、C5 级7 条、C6 级10 条。术后半年复查彩色多普勒超声显示,40 条肢体(42.1%)瓣膜功能恢复正常、21 条肢体(22.1%)脉瓣膜功能改善、23 条肢体(24.2%)无法判断、11 条肢体(11.6%)瓣膜功能不全加重,加重的肢体中10 条术前CEAP 分级为C5~6 级;95 条肢体术后平均反流持续时间(VCT)与峰值流速(Vmax)均较术前明显降低(均P<0.05)。结论:PDVI 患者行下肢浅静脉曲张手术能在一定程度上改善深静脉瓣膜功能,但是对于C5~6 级患者,由于瓣膜功能破坏较严重,建议同时行深静脉瓣膜修复手术。


Influence of surgery for superficial varicose veins on function of deep venous valves in lower extremities

Abstract

Objective: To investigate the impact of operation for lower extremity superficial varicose veins on function of deep venous valves in patients with primary deep vein valvular incompetence (PDVI). Methods: The clinical data of 94 PDVI patients (95 limbs) undergoing surgery for superficial varicose veins of the lower extremity were retrospectively analyzed. The changes in deep venous valve function before and after operation were compared. Results: All the 95 limbs were definitely diagnosed to have PDVI by color Doppler ultrasonography before operation, in which according to CEAP classification, 31 limbs were classified as C2, 22 were C3, 25 were C4, 7 were C5, and 10 were C6, respectively. Results of color Doppler ultrasonography half a year after operation showed that valvular function returned to normal in 40 limbs (42.1%), improved in 21 limbs (22.1%), was unable to be determined in 23 limbs (24.2%), and the valvular incompetence was aggravated in 11 limbs (11.6%), 10 of which were classified as C5–6 by preoperative CEAP classification; the average valve closure time (VCT) and maximum velocity (Vmax) of the 95 limbs were all significantly decreased compared with preoperative values (both P<0.05). Conclusion: The valvular function of deep veins in PDVI patients may be improved to some extent after operation for lower extremity superficial varicose veins. However, for patients with C5–6 classification, the synchronous repair of deep vein valves is recommended because of the serious damage of their valvular function.


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引用

引用本文: 天 邱, 曙光 郭, 伟 方, 兴立 周, 明生 彭, 存平 尹, 鹏 张, 宏斌 苏, 铠 张. 下肢浅静脉曲张手术对深静脉瓣膜功能影响的临床研究[J]. 中国普通外科杂志, 2015, 24(6): 852-856.
Cite this article as: QIU Tian, GUO Shuguang, FANG Wei, ZHOU Xingli, PENG Mingsheng, YIN Cunping, ZHANG Peng, SU Hongbin, ZHANG Kai . Influence of surgery for superficial varicose veins on function of deep venous valves in lower extremities[J]. Chin J Gen Surg, 2015, 24(6): 852-856.