Karadeniz-Bilgili Mirace Yasemin, Basar Halil, Simsir Ilknur, Unal Birsen, Batislam Ertan
Department of Radiology, Kirikkale University School of Medicine, Süleyman Demirel Hospital, Kirikkale, Turkey.
Pediatr Radiol. 2003 Sep;33(9):603-6. doi: 10.1007/s00247-003-0975-9. Epub 2003 Jul 18.
Although there is much evidence supporting a relationship between primary varicocoele and venous incompetence of the saphenofemoral junction in adults, there is no evidence for such a relationship during adolescence. Because of the effect of age and future occupation (standing upright for long periods) on the aetiology, pathogenesis and frequency of varicose veins of the lower extremity and incompetence of saphenofemoral junctions in adulthood, a comparison during adolescence is appropriate.
On the basis of a close physiopathological and haemodynamic relationship between primary varicose veins and primary varicocoele, we decided to evaluate the competence of the saphenofemoral junctions in a selected group of adolescents affected by primary varicocoele and compare these results with age-matched healthy adolescents.
Twenty-five adolescents with primary varicocoele and 23 age-matched healthy controls were included in the study. In all cases physical examination and colour Doppler US was used to diagnose or exclude the presence of primary varicocoele and to evaluate the continence of the saphenofemoral junction.
On the right side, 10 of 25 varicocoele patients and on the left side 11 of 25 varicocoele patients had incompetence of the saphenofemoral junction. For the control patients the incidence was 2/23 on the right side and 4/23 on the left side. The difference is statistically significant.
We demonstrated high concurrence of varicocoele and valvular incompetence of the saphenofemoral junction in a particular adolescent group. We suggest clinical examination and US assessment of the saphenofemoral junctions of adolescents affected by varicocoele in order to detect the early diagnosis of venous insufficiency of the lower limbs among these patients.
尽管有大量证据支持成人原发性精索静脉曲张与大隐静脉股静脉交界处静脉功能不全之间存在关联，但在青少年时期尚无此类关联的证据。由于年龄和未来职业（长时间站立）对下肢静脉曲张的病因、发病机制和发生率以及成年期大隐静脉股静脉交界处功能不全的影响，在青少年时期进行比较是合适的。
基于原发性下肢静脉曲张与原发性精索静脉曲张之间密切的生理病理和血流动力学关系，我们决定评估一组受原发性精索静脉曲张影响的青少年中大隐静脉股静脉交界处的功能，并将这些结果与年龄匹配的健康青少年进行比较。
本研究纳入了25名患有原发性精索静脉曲张的青少年和23名年龄匹配的健康对照者。在所有病例中，均采用体格检查和彩色多普勒超声来诊断或排除原发性精索静脉曲张的存在，并评估大隐静脉股静脉交界处的功能。
右侧，25名精索静脉曲张患者中有10名大隐静脉股静脉交界处功能不全；左侧，25名精索静脉曲张患者中有11名大隐静脉股静脉交界处功能不全。对照组患者右侧发生率为2/23，左侧为4/23。差异具有统计学意义。
我们证实在特定青少年群体中，精索静脉曲张与大隐静脉股静脉交界处瓣膜功能不全高度并发。我们建议对受精索静脉曲张影响的青少年进行大隐静脉股静脉交界处的临床检查和超声评估，以便在这些患者中早期诊断下肢静脉功能不全。
