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静脉曲张手术的临床、超声及组织学表现

Clinical, ultrasonographic and histological findings in varicose vein surgery.

作者信息

Porciunculla Moacir de Mello, Leiderman Dafne Braga Diamante, Altenfeder Rodrigo, Pereira Celina Siqueira Barbosa, Fioranelli Alexandre, Wolosker Nelson, Castelli Junior Valter

机构信息

. Medical Science Faculty of the Santa Casa of São Paulo, São Paulo/SP, Brasil.

. Hospital Israelita Albert Einstein, São Paulo/SP, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2018 Aug;64(8):729-735. doi: 10.1590/1806-9282.64.08.729.

Abstract

OBJECTIVE

This study aims to correlate the demographic data, different clinical degrees of chronic venous insufficiency (CEAP), ultrasound findings of saphenofemoral junction (SFJ) reflux, and anatomopathological findings of the proximal segment of the great saphenous vein (GSV) extracted from patients with primary chronic venous insufficiency (CVI) submitted to stripping of the great saphenous vein for the treatment of lower limb varicose.

METHOD

This is a prospective study of 84 patients (110 limbs) who were submitted to the stripping of the great saphenous vein for the treatment of varicose veins of the lower limbs, who were evaluated for CEAP clinical classification, the presence of reflux at the SFJ with Doppler ultrasonography, and histopathological changes. We study the relationship between the histopathological findings of the proximal GSV withdrawal of patients with CVI with a normal GSV control group from cadavers.

RESULTS

The mean age of the patients was higher in the advanced CEAPS categories when comparing C2 (46,1 years) with C4 (55,7 years) and C5-6(66 years), as well as C3 patients (50,6 years) with C5-6 patients. The normal GSV wall thickness (mean 839,7 micrometers) was significantly lower than in the saphenous varicose vein (mean 1609,7 micrometers). The correlational analysis of reflux in SFJ with clinical classification or histopathological finding did not show statistically significant findings.

CONCLUSIONS

The greater the age, the greater the clinical severity of the patients. The GSV wall is thicker in patients with lower limb varicose veins, but those histopathological changes are not correlated with the disease's clinical severity or reflux in the SFJ on a Doppler ultrasound.

摘要

目的

本研究旨在关联人口统计学数据、慢性静脉功能不全(CEAP)的不同临床程度、隐股静脉交界处(SFJ)反流的超声检查结果,以及从接受大隐静脉剥脱术治疗下肢静脉曲张的原发性慢性静脉功能不全(CVI)患者身上提取的大隐静脉(GSV)近端段的解剖病理学检查结果。

方法

这是一项对84例患者(110条肢体)的前瞻性研究,这些患者接受了大隐静脉剥脱术以治疗下肢静脉曲张,对其进行CEAP临床分类评估、通过多普勒超声检查SFJ处有无反流以及组织病理学变化评估。我们研究了CVI患者GSV近端段的组织病理学检查结果与来自尸体的GSV正常对照组之间的关系。

结果

将C2(46.1岁)与C4(55.7岁)和C5 - 6(66岁)进行比较时,以及将C3患者(50.6岁)与C5 - 6患者进行比较时,在CEAP高级别类别中患者的平均年龄更高。正常GSV壁厚度(平均839.7微米)显著低于大隐静脉曲张静脉(平均1609.7微米)。SFJ反流与临床分类或组织病理学检查结果的相关性分析未显示出具有统计学意义的结果。

结论

年龄越大,患者的临床严重程度越高。下肢静脉曲张患者的GSV壁更厚,但这些组织病理学变化与疾病的临床严重程度或多普勒超声检查中SFJ处的反流无关。

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