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[下肢及骨盆血栓形成后综合征的诊断与外科治疗现状]

[Current status of the diagnosis and surgical treatment of the postthrombophlebitic syndrome of the lower extremities and pelvis].

作者信息

Shalimov A A, Sukharev I I, Riabyshev A V, Turaev P I, Soroka A M

出版信息

Kardiologiia. 1978 Aug;18(8):50-4.

PMID:691966
Abstract

The clinical, phlebographic, and hemodynamic signs of the postthrombophlebitic syndrome were studied. In 99.3% of patients the disease was found to be attended with edema of the extremities, in 100%--with the pain syndrome, in 64.2%--with pigmentation, in 59.7%--with tissue induration, and in 53.6% of patients--with trophic ulcers. A study of microcirculation revealed a significant increase of the time of tissue resorption. The venous pressure proved to be increased; the degree of its normalization is an objective test for the success of the operation. The volume blood flow in the affected extremity was 1.8 times that in the normal extremity. Contrast X-ray examination of the veins showed phlebographic signs of the disease. Reconstructive operations on the deep veins were performed in 109 patients; 85.4% had good remote results. Linton's operation was performed on 29 patients, Cockett's operation--on 17, and Felder's operation--on 8 patients; good remote results were noted in 75.7% of cases. For determining the tactics of the treatment and its prognostication, a classification of the postthrombophlebitic syndrome is suggested.

摘要

对血栓形成后综合征的临床、静脉造影及血液动力学征象进行了研究。发现99.3%的患者伴有肢体水肿,100%伴有疼痛综合征,64.2%伴有色素沉着,59.7%伴有组织硬结,53.6%的患者伴有营养性溃疡。微循环研究显示组织吸收时间显著延长。静脉压升高;其恢复正常的程度是手术成功与否的客观指标。患侧肢体的血流量是正常肢体的1.8倍。静脉造影X线检查显示了该病的静脉造影征象。对109例患者实施了深静脉重建手术;85.4%获得了良好的远期效果。对29例患者实施了林顿手术,17例实施了科克特手术,8例实施了费尔德手术;75.7%的病例获得了良好的远期效果。为确定治疗策略及其预后,提出了血栓形成后综合征的分类方法。

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