Louagie Y, Van Ruyssevelt P, el Hammouti F, Theys S, Janssens T, Buche M, Schoevaerdts J C
Department of Thoracic and Cardiovascular Surgery, Academic Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium.
J Cardiovasc Surg (Torino). 1990 Jul-Aug;31(4):416-23.
From 1974 to 1988, interruption of the superficial femoral vein (SFV) was performed to prevent pulmonary embolism (PE) in 73 patients. The mean age of the patients was 62 years. Phlebography showed thrombi in the following localizations: calf veins (67.3%), superficial femoral or popliteal veins (56.6%), common femoral veins (19.5%) and iliac veins (2.7%). A floating thrombus in the popliteal or femoral vein was the main indication for surgery in 97.3% of patients. Pulmonary embolism had occurred in 76.7% and was associated with neoplasm in 13.7%. Ligation of the SFV was performed in 93 limbs and completed iliac or femoral thrombectomy in 32.3%. The procedure was performed under locoregional anesthesia in 82.9% of the cases. Hospital mortality was 1.4% and 3 year survival, considering only PE related deaths was 95.3 +/- 2.7%. Follow-up was complete for all patients and averaged 3.0 years, for a 3 years PE-free rate of 90.8 +/- 3.6%. Persistent symptoms included increased limb tenseness in 12.5% and mild ankle edema in 25%. Bilateral strain-gauge plethysmography (SGP) was obtained in 65 limbs. The time necessary to obtain a 50, 75 and 100% decrease in calf volume (respectively T1/2, T3/4 and TT) was calculated for the operated limb and compared with the untreated limbs used as controls. A prolongation of T1/2 from 2.5 +/- 0.3 sec in controls to 4.3 +/- 0.4 sec in the operated limb (p less than 0.01) was found. Thus, our experience with ligation of the superficial femoral vein is favourable since long-term ill effects have been minimal and strain gauge plethysmography (SGP) showed only mildly altered venous drainage.(ABSTRACT TRUNCATED AT 250 WORDS)
1974年至1988年期间，对73例患者进行了股浅静脉（SFV）阻断术以预防肺栓塞（PE）。患者的平均年龄为62岁。静脉造影显示血栓位于以下部位：小腿静脉（67.3%）、股浅静脉或腘静脉（56.6%）、股总静脉（19.5%）和髂静脉（2.7%）。腘静脉或股静脉内的漂浮血栓是97.3%患者手术的主要指征。76.7%的患者发生过肺栓塞，其中13.7%与肿瘤相关。93条肢体进行了股浅静脉结扎术，32.3%完成了髂静脉或股静脉血栓切除术。82.9%的病例在局部麻醉下进行手术。医院死亡率为1.4%，仅考虑与肺栓塞相关的死亡，3年生存率为95.3±2.7%。所有患者均完成随访，平均随访3.0年，3年无肺栓塞率为90.8±3.6%。持续症状包括12.5%的患者肢体张力增加和25%的患者轻度踝关节水肿。对65条肢体进行了双侧应变计体积描记法（SGP）检查。计算手术肢体小腿体积减少50%、75%和100%（分别为T1/2、T3/4和TT）所需的时间，并与作为对照的未治疗肢体进行比较。发现T1/2从对照组的2.5±0.3秒延长至手术肢体的4.3±0.4秒（p<0.01）。因此，我们进行股浅静脉结扎术的经验是良好的，因为长期不良影响极小，应变计体积描记法（SGP）显示静脉引流仅略有改变。（摘要截取自250字）
