Klonizakis M, Yeung J M-C, Lingam K, Nash J R, Manning G, Donnelly R
School of Medical and Surgical Sciences, Centre for Integrated Systems Biology and Medicine, University of Nottingham Medical School, Derby City General Hospital, Uttoxeter Road, Derby DE22 3DT, UK.
Eur J Vasc Endovasc Surg. 2006 Apr;31(4):434-8. doi: 10.1016/j.ejvs.2005.10.017. Epub 2005 Dec 15.
To evaluate the effects of varicose vein surgery on cutaneous microvascular perfusion and vasodilator responses to acetylcholine (Ach) and sodium nitroprusside (SNP) in the gaiter area of patients with great saphenous vein insufficiency.
Twenty-nine patients with isolated great saphenous vein incompetence attended three study mornings (before surgery, and 6-8 weeks and 6 months after sapheno-femoral ligation+partial stripping) during which cutaneous microvascular responses were measured in the supine and standing positions using laser Doppler fluximetry (LDF) combined with incremental-dose iontophoretic administration of endothelial-dependent (Ach) and -independent (SNP) vasodilators.
Varicose vein surgery had no significant effect on baseline cutaneous perfusion or the microvascular response to Ach: e.g. peak vasodilator responses to the 1000 microC stimulus were mean 58 SEM 7, 64 SEM 6 and 65 SEM 7PU on the pre-operative, 6-8 weeks and 6 months assessments. In contrast, the corresponding responses to SNP were significantly increased following surgery: e.g. at 2000 microC, mean 63 SEM 9, 142 SEM 4 and 157 SEM 9PU (p<0.0001) in the upright position.
Sapheno-femoral ligation and partial stripping in patients with great saphenous vein insufficiency improves endothelial-independent cutaneous vasodilator function at the gaiter area, which may at least partly explain the benefits of surgery in reducing the risk of venous ulceration.
评估大隐静脉功能不全患者的静脉曲张手术对其小腿下部皮肤微血管灌注以及对乙酰胆碱（Ach）和硝普钠（SNP）的血管舒张反应的影响。
29例单纯性大隐静脉功能不全患者在三个研究日上午（手术前、大隐静脉-股静脉结扎+部分剥脱术后6-8周和6个月）接受检查，期间采用激光多普勒血流仪（LDF）结合递增剂量离子电渗法给予内皮依赖性（Ach）和非内皮依赖性（SNP）血管舒张剂，分别在仰卧位和站立位测量皮肤微血管反应。
静脉曲张手术对基线皮肤灌注或对Ach的微血管反应无显著影响：例如，对1000微库仑刺激的最大血管舒张反应在术前、6-8周和6个月评估时分别为平均58±7、64±6和65±7灌注单位（PU）。相比之下，术后对SNP的相应反应显著增加：例如，在2000微库仑时，站立位分别为平均63±9、142±4和157±9PU（p<0.0001）。
大隐静脉功能不全患者行大隐静脉-股静脉结扎和部分剥脱术可改善小腿下部皮肤非内皮依赖性血管舒张功能，这可能至少部分解释了手术在降低静脉溃疡风险方面的益处。
