Askar O, Kassem K A
J Cardiovasc Surg (Torino). 1975 Jan-Feb;16(1):79-94.
In a clinico-radiological survey of 150 cases of varicose veins of the leg, 44 had primary varicosities with no dermal complications; their venograms showed patency of the deep veins of the leg. In 106 cases presenting dermal complications, venographic evidence of deep venous occlusion was present. The dermal complications of varicosities are, therefore, always secondary to deep venous occlusion. Deep venous occlusion of the leg was confined to the lower 1/3 of the leg in 58% of the cases occurring as a complication of silent varices. In 15% it involved the upper 1/3. This lesion complicated trauma and surgical operations. In 5% thrombosis occurred in the muscular sinusoids as a complication of septicaemia. In 22%, deep venous occlusion in lower 1/3 of the leg extended to the middle and upper thirds with a corresponding ascending aggravation of the clinical picture. The underlying factors in the pathogenesis of dermal complications are discussed as well as the role of the lymphatics. The reported classification of deep venous occlusion of the leg may prove of value if a venographic study is not feasible. A review of the various types of treatment is presented in the light of these informations.
在一项对150例下肢静脉曲张患者的临床放射学调查中，44例为原发性静脉曲张，无皮肤并发症；其静脉造影显示下肢深静脉通畅。在106例出现皮肤并发症的病例中，存在深静脉闭塞的静脉造影证据。因此，静脉曲张的皮肤并发症总是继发于深静脉闭塞。作为隐匿性静脉曲张并发症发生的病例中，58%的下肢深静脉闭塞局限于小腿下1/3。15%的病例累及上1/3。这种病变并发于创伤和外科手术。5%的病例中，肌窦血栓形成是败血症的并发症。22%的病例中，小腿下1/3的深静脉闭塞扩展至中1/3和上1/3，临床症状相应地进行性加重。文中讨论了皮肤并发症发病机制中的潜在因素以及淋巴管的作用。如果静脉造影研究不可行，所报道的下肢深静脉闭塞分类可能具有价值。根据这些信息，对各种治疗方法进行了综述。
