腔镜深筋膜下交通静脉离断联合透光旋切治疗下肢静脉性溃疡.docVIP

腔镜深筋膜下交通静脉离断联合透光旋切治疗下肢静脉性溃疡【摘要】 目的 探讨腔镜深筋膜下交通静脉离断术(SEPS)联合透光旋切系统TrivexTM治疗慢性下肢静脉溃疡的临床疗效。方法 手术治疗15例(17条患肢),下肢静脉性溃疡采用腔镜下交通静脉离断,大隐静脉内翻剥脱,曲张静脉团透光旋切术,创面用康惠尔清创胶换药。结果 全组手术后恢复良好,症状消失,浅静脉曲张消失,未发生明显并发症,随访3个月~2年无皮肤溃疡及浅静脉曲张复发,12例静脉性溃疡短期愈合,最短术后7 d愈合,最长8周愈合。结论 腔镜深筋膜下交通静脉离断术安全有效,损伤小,溃疡愈合时间短,是治疗下肢静脉功能不全性溃疡的有效方法和重要组成部分。 【关键词】静脉功能不全;内镜;血管外科手术 The clinical curative effect treating the chronic ulcer in veins of Lower extremity SONG Pei-heng,CHEN De-xing,LI Gui-bin.Department of orthopedics,Qian wei Hospital of Jilin,Province,Changchun 130012,China 【Abstract】 Objective To discuss the clinical curative effect treating the chronic ulcer in veins of lower extremity by SEPS(subfascial endoscopic perforator vein surgery)and TriVextm.Methods Treated 15 cases(17 affected limbs were operated).Treat the chronic ulcer in veins of lower extremity by SEPS,and the great saphenous veins were inversed and denuded.The group of varicose vein was cut by TriVextm.Debride the wound surface by KangHuiEr.Results All the cases? postoperative recovery were perfect,the symptom disappeared,and the superficial varicose vein disappeared,no conspicuous complications.Follow-up visit(3 months to 2 years)shows no dermal ulce or the superficial varicose vein.There were 12 cases healing with short period heal.The shortest was 7 days and the longest was 8 weeks.Conclusion SEPS is safe and utility,the injury is smaller,and the period of healing is shorter.That is an effective method and important ingredient. 【Key words】Vein functional defect impaired; Endoscope; Vascular surgery operation 下肢慢性静脉功能不全(chronic venous insufficieney,CVI)是血管外科常见病,主要表现浅静脉曲张,肢体肿胀,足靴区皮肤营养障碍,其中最严重的表现是静脉性溃疡。小腿交通支功能不全是下肢慢性静脉功能不全中导致皮肤发生营养障碍主要因素,皮肤溃疡发生后并发感染,创面用各种方法治疗经久不愈。我院2007年2月至2009年4月采用内镜深筋膜下交通静脉离断术(subfascial endoscopic perforator vein surgery,SEPS),大隐静脉高位结扎内翻剥脱、联合透光旋切系统(TrivexTM)即透照下动力静脉切除术(transilluminated powered phlebectomy,TIPP)治疗15例(17条患肢)下肢静脉性溃疡患者进行了SEPS手术,为探讨腔镜深筋膜下交通静脉离断术(SEPS)联合透光旋切系统TrivexTM治疗慢性下肢静脉溃疡的临床疗效,报告如下。 1 资料