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淋巴水肿 （Lymphedema） Lymphedema is generally classified as primary and secondary. Primary： Secondary： Secondary lymph-edema involve resection or ablation of regional lymph nodes by surgery, radiation therapy, tumor invasion, direct trauma, or less commonly, an infectious process. 1.Congenital vascular malformation AVF K-T syndrome 2.Carotid body tumor 谢谢大家 sjming01@163.com 小腿深静脉由胫前、胫后和腓静脉组成，上行汇合成腘静脉, 进入内收肌管后成为股浅静脉，上行到大腿上部与股深静脉汇合为股总静脉。上行越过腹股沟韧带即为髂外静脉，与髂内静脉汇合形成髂总静脉，与对侧髂总静脉汇合形成下腔静脉。 Classification of Chronic Lower Extremity Venous Disease C Clinical signs (grade0–6 , supplemented by “A” for asymptomatic and “S” for asymptomatic presentation E Etilogic classification (congential, primary, secondary) A Anatomic distribution (superficial, deep, or perforator, alone or in combination) P Pathophysiologic dysfunction (reflux or obstruction, alone or in combination) CLINICAL CLASSIFICATION (C0–6 ) Any limb with possible chronic venous disease is first placed into one of seven clinical classes (C0–6 ) according to the objective signs of disease. Clinical Classification of Chronic Lower Extremity Venous Disease Class 0 No visible or palpable signs of venous disease Class 1 Telangiectasia, reticular veins, malleolar（踝的） flare Class 2 Varicose veins Class 3 Edema without skin changes Class 4 Skin changes ascribed to venous disease (e.g., pigmentation(色素沉着), venous eczema（湿疹）, lipo-dermatosclerosis（硬皮病） Class 5 Skin changes as defined above with healed ulceration Class 6 Skin changes as defined above with active ulceration 原发性静脉曲张 (primary varicose vein) ⒈遗传因素： 先天因素导致静脉瓣膜缺失，静脉 壁变薄等 ⒉增加静脉内静水压的任何因素： ⑴重体力劳动者 长期站立或坐姿工作者 ⑵慢性咳嗽 习惯性便秘 ⑶妊娠时 ①患肢酸胀不适： 站立静止状态下最明显 ②浅静脉曲张 呈现蜿蜒扩张迂曲状态，有时呈瘤样 扩张，越靠近肢体远端越明显 ③肢体肿胀，色素沉着及顽固性溃疡： “足靴区皮肤色素沉着及顽固性溃疡 大隐静脉瓣膜功能试验 (Trendelenburg 试验) 深静脉通畅试验(Perthes试验) 交通静脉瓣膜功能试验(Pratt试验) 其他检查: 多普勒超声、血流图 、静脉压测定、静脉造影（上行、下行）、CTV/MRV