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[急性非典型性静脉曲张性血栓性静脉炎的手术治疗策略]

[Surgical treatment tactics for acute varicothrombophlebitis atypical forms].

作者信息

Rusyn V I, Riashko M I, Sirchak S S, Lopit V M, Krasnopol's'ka O S

出版信息

Klin Khir. 2014 Jun(6):40-2.

Abstract

Changes of phlebohemodynamics under control of ultrasonographic investigation were registered in 237 patients, suffering an acute varicothrombophlebitis (AVTH) of superficial veins of lower extremities (LE). In 21 patients atypical forms of AVTH were revealed, including reflux toward a big subcutaneous vein (BSV) of the leg and/or small subcutaneous vein (SSV); reflux toward insufficient indirect veins on hip and shin; reflux toward insufficient direct perforant veins. For atypical forms of AVTH the urgent operations on hip and shin were performed: crossectomy, short or long stripping, phlebectomy and/or scleroobliteration of tributaries; open subfascial resection (mini-Linton); deferred operations: phlebectomy of the BSV/SSV tributaries, open scleroobliteration, subfascial resection (mini-Linton). Systematization of the AVTH forms in accordance to the LE segments have permitted to determine strategy and tactics of the patients treatment, what have important practical significance.

摘要

在超声检查的控制下,对237例患有下肢浅静脉急性曲张血栓性静脉炎(AVTH)的患者进行了静脉血液动力学变化的记录。在21例患者中发现了非典型形式的AVTH,包括向腿部大皮下静脉(BSV)和/或小皮下静脉(SSV)反流;向髋部和小腿的间接静脉功能不全处反流;向直接穿通静脉功能不全处反流。对于非典型形式的AVTH,在髋部和小腿进行了紧急手术:横切术、短或长段剥脱术、静脉切除术和/或支流硬化闭塞术;开放式筋膜下切除术(迷你Linton手术);延期手术:BSV/SSV支流静脉切除术、开放式硬化闭塞术、筋膜下切除术(迷你Linton手术)。根据下肢节段对AVTH形式进行系统化,有助于确定患者的治疗策略和战术,具有重要的实际意义。

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