[1]柳小刚,刘咸罗,钱小星,等.下肢静脉性溃疡的外科微创治疗[J].中国微创外科杂志,2008,08(3):263-265.
　Liu Xiaogang,Liu Xianluo,Qian Xiaoxing,et al.Minimally Invasive Surgery for Venous Leg Ulcer[J].Chinese Journal of Minimally Invasive Surgery,2008,08(3):263-265.
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下肢静脉性溃疡的外科微创治疗()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年3期
页码:
263-265
栏目:
出版日期:
2008-10-25

文章信息/Info

Title:
Minimally Invasive Surgery for Venous Leg Ulcer
作者:
柳小刚; 刘咸罗; 钱小星; 胡开兵
安徽医科大学第四临床学院合肥市第二人民医院血管外科,合肥230011
Author(s):
Liu Xiaogang;  Liu Xianluo;  Qian Xiaoxing;  et al.
Department of Vascular Surgery, Second People’s Hospital of Hefei, Fourth Clinical College of Anhui Medical University, Hefei 230011, China
关键词:
下肢静脉性溃疡; 外科微创治疗; 治疗结果
Keywords:
Venous leg ulcer; Minimally invasive surgery; Therapeutic outcomes
分类号:
R654.3
文献标志码:
A
摘要:
目的探讨下肢静脉性溃疡外科微创治疗的效果。方法对31例(33侧患肢)下肢静脉性溃疡通过静脉造影检查明确引起溃疡的原发病变，根据患肢血流动力学异常的种类和程度对10例(11侧患肢)行高位大隐静脉结扎联合静脉腔内激光治疗术;17例(18侧患肢)行高位大隐静脉结扎联合静脉腔内激光治疗、内镜深筋膜下交通静脉离断术;4例(4侧患肢)行高位大隐静脉结扎联合静脉腔内激光治疗、内镜深筋膜下交通静脉离断和股浅静脉瓣膜包窄术。溃疡一律行周缘环行缝扎。结果术后33侧患肢浅静脉曲张均消失，色素沉着、湿疹样病变均明显减轻;24侧小腿酸胀沉重感、疼痛、水肿12～16 d消失;溃疡18～40 d内愈合。随访1～36个月，平均14.8月，3侧(9.1％)肢体溃疡复发。结论纠正浅静脉、交通支静脉、深静脉功能不全和重视溃疡创面的处理是治疗下肢静脉性溃疡的有效疗法，静脉腔内激光治疗、内镜深筋膜下交通静脉离断术操作简便、微创、安全，联合股浅静脉瓣膜包窄术可以有效地减少下肢静脉性溃疡的复发。
Abstract:
ObjectiveTo study the efficacy of minimally invasive surgery for venous leg ulcer.MethodsA total of 31 patients with venous leg ulcer (33 limbs) were examined with venography to identify the primary lesion that resulted the ulcer. According to the type and degree of hemodynamic abnormality, high ligation of the great saphenous vein combined with endovenous laser treatment was performed on 10 patients (11 limbs), high ligation of the great saphenous vein combined with endovenous laser treatment and subfascial endoscopic perforator surgery were carried out in 17 cases (18 limbs),and high ligation of the great saphenous vein combined with endovenous laser treatment, subfascial endoscopic perforator surgery, and external banding valvuloplasty of the superficial femoral vein were done in 4 cases (4 limbs). In all the cases, the ulcers were circumferentially ligated at the same time.ResultsAfter the operations, superficial varicosis, pigmentations, and eczematous relieved remarkably in the 33 limbs. In 24 legs, heavyfeeling, ache, and edema disappeared 12-16 days postoperation. The ulcers of the 33 legs healed in 18-40 days after the operations. During a 1 to 36month followup (mean, 14.8 months), ulceration recurred in 3 legs (9.1％).ConclusionsIt is effective to correct the incompetence of the superficial, perforating, and deep veins and manage the surface of ulcerations for venous leg ulcer. Endovenous laser treatment and subfascial endoscopic perforator surgery are easyperforming, minimally invasive, and safe operations. The recurrence of leg ulceration can be reduced by external banding valvuloplasty of the superficial femoral vein.

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更新日期/Last Update: 2013-10-22