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[小腿大营养性溃疡水平静脉反流手术矫正的比较分析]

[Comparative analysis of horizontal venous reflux surgical correction by large trophic lower leg ulcers].

作者信息

Askerov N G, Zhukov A O, Malinina V N

出版信息

Khirurgiia (Mosk). 2009(10):29-32.

Abstract

Subfascial perforant veins dissection (SPVD) of the lower leg was performed in patients with chronic venous insufficiency CEAP class 5 and 6. 252 operations were performed in 236 patients. All patients had trophic lesions (skin hyperpigmentation and lipodermatosclerosis) 218 (92,4%) patients had trophic lower leg ulcer to the time of operation. 30 patients had earlier performed phlebectomy. Open SPVD was performed in 122 cases, endoscopic technique was used in 114 patients. Comparative analysis of these two methods was performed. Long-term results were accessed with the use of SF-36 questionnaire. Efficacy, pathogenetic validity and economic expedience of SPVD by large trophic lower leg ulcers are confirmed by the decrease of postoperative complications and recurrence rate. The horizontal venous reflux elimination and trophic ulcer dissection with intraoperative skin plasty allow a significant improvement of treatment results.

摘要

对慢性静脉功能不全CEAP分级5级和6级的患者进行小腿筋膜下穿支静脉剥离术(SPVD)。236例患者共进行了252例手术。所有患者均有营养性病变(皮肤色素沉着和脂性硬皮病),218例(92.4%)患者在手术时患有小腿营养性溃疡。30例患者此前接受过静脉切除术。122例采用开放SPVD,114例采用内镜技术。对这两种方法进行了对比分析。使用SF - 36问卷评估长期结果。术后并发症和复发率的降低证实了SPVD对小腿大面积营养性溃疡的疗效、病因学合理性和经济便利性。术中皮肤整形消除水平静脉反流并切除营养性溃疡可显著改善治疗效果。

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