Fitridge R A, Dunlop C, Raptis S, Thompson M M, Leppard P, Quigley F
Department of Surgery, University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia, Australia.
Aust N Z J Surg. 1999 Mar;69(3):214-6. doi: 10.1046/j.1440-1622.1999.01525.x.
This study was undertaken to determine the haemodynamic effect of incompetent calf perforating veins in patients with uncomplicated varicose veins and long saphenous incompetence.
Thirty-eight limbs from 35 patients were studied. All patients had uncomplicated varicose veins with both long saphenous and calf perforator incompetence on duplex ultrasonography. Patients were randomized to have incompetent calf perforators ligated or left intact, in addition to saphenofemoral junction ligation, strip of long saphenous vein to knee and stab avulsion of any visible varicosities in the leg. Patients were assessed with air plethysmography pre-operatively and 3 months postoperatively.
Superficial venous surgery improved venous volume, venous filling index and ejection fraction in the patient cohort. No significant haemodynamic difference was demonstrated between the two groups of patients who were randomized.
At present, the results of this study do not support the use of routine perforator ligation during superficial surgery for uncomplicated varicose veins.
本研究旨在确定单纯性静脉曲张且大隐静脉功能不全患者小腿交通静脉功能不全的血流动力学影响。
对35例患者的38条肢体进行了研究。所有患者经双功超声检查均患有单纯性静脉曲张，同时存在大隐静脉和小腿交通静脉功能不全。患者被随机分为两组，一组除行大隐静脉股静脉交界处结扎、大隐静脉剥脱至膝关节以及对腿部任何可见的静脉曲张进行点状剥脱外，还结扎功能不全的小腿交通静脉；另一组则保持小腿交通静脉完整。术前及术后3个月采用空气体积描记法对患者进行评估。
浅表静脉手术改善了患者队列中的静脉容量、静脉充盈指数和射血分数。随机分组的两组患者之间未显示出显著的血流动力学差异。
目前，本研究结果不支持在单纯性静脉曲张的浅表手术中常规进行交通静脉结扎。
