Wang Shen-ming, Hu Zuo-jun, Li Song-qi, Huang Xue-ling, Ye Cai-sheng
Department of Vascular Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Wai Ke Za Zhi. 2005 Jul 1;43(13):853-6.
To verify the role and effect of external vavuloplasty in the treatment of chronic venous insufficiency (CVI) of lower extremity.
Thirty patients with CVI of bilateral lower extremities were enrolled to accept surgical management of vein systems. Both limbs of each patient were randomized into two groups respectively according to the operating style. One limb was given external vavuloplasty of the superficial femoral vein and surgery of superficial venous system (group A), the another limb was only given the surgery of superficial venous system (group B). The effect comparison between both limbs of each patient and two groups by color duplex scanning, color doppler velocity profile (CDVP), air plethysmography and CEAP score system one month and 3 years after operation.
All 60 limbs of 30 cases were CEAP C(2)-C(4) with degree III reflux (Kistner's method) in the deep veins confirmed by color duplex scanning and venography. In 1 month and 3 years after surgery, all the indexes of the limb in the group A were dramatically improved compared with those of the limbs in the group B. The average value of venous reflux degree, reflux volume, and venous filling index (VFI) had significant difference between the two groups (P < 0.001). In 3 years after surgery, there was significant difference between the two groups on ejective fraction (EF)and residual volume fraction (RVF) (P < 0.05) and CEAP clinical score (P < 0.001).
External vavuloplasty of deep vein may reduce the reflux volume of the affected deep vein and improve the valve function, and can result in better outcomes when combined with surgery of the superficial venous system.
验证股静脉外瓣膜成形术在治疗下肢慢性静脉功能不全(CVI)中的作用及效果。
选取30例双侧下肢CVI患者接受静脉系统手术治疗。根据手术方式将每位患者的双下肢分别随机分为两组。一组行股浅静脉外瓣膜成形术及浅静脉系统手术(A组),另一组仅行浅静脉系统手术(B组)。术后1个月及3年,通过彩色双功能超声扫描、彩色多普勒速度剖面图(CDVP)、空气容积描记法及CEAP评分系统对每位患者的双下肢及两组进行效果比较。
30例患者的60条下肢经彩色双功能超声扫描及静脉造影证实均为CEAP C(2)-C(4)级,深静脉反流程度为Ⅲ级(Kistner法)。术后1个月及3年,A组下肢各项指标较B组均有显著改善。两组静脉反流程度、反流容积及静脉充盈指数(VFI)的平均值差异有统计学意义(P<0.001)。术后3年,两组在射血分数(EF)、残余容积分数(RVF)及CEAP临床评分方面差异有统计学意义(P<0.05),在CEAP临床评分方面差异有高度统计学意义(P<0.001)。
深静脉外瓣膜成形术可减少患侧深静脉反流容积,改善瓣膜功能,与浅静脉系统手术联合应用效果更佳。