大/小隐静脉主干分段结扎+属支Muller术治疗下肢浅静脉曲张疗效分析

Effect of combined stepwise GSV/CSV ligation with muller’s phlebectomy on superficial varicosis of lower limbs

关键词:  下肢浅静脉曲张  结扎  疗效

Key words:  superficial varicosis of lower limbs, ligation, therapeutic effect

摘要:

［目的］ 探讨准确标记和抽剥器引导下大/小隐静脉（great/small saphenous vein，GSV/SSV）主干分段结扎+属支muller术治疗下肢浅静脉曲张的价值。［方法］ 术前准确标记和术中抽剥器静脉内引导下，65例（72个肢体）C3~6 级下肢浅静脉曲张患者行GSV或GSV/SSV分段结扎+属支Muller术，比较临床表现严重程度评分（venous clinical severity score，VCSS）术前术后变化。［结果］ 术后10例（11条患肢）一过性肿胀，1例切口感染，1例胫前残留曲张静脉属支，1例小腿压迫性溃疡，均经对症处理后缓解。和术前相比较，术后90 d的VCSS明显下降（7.0±4.2 vs 1.5±0.3，t=2.25，P≤0.05）。［结论］ 准确标记和抽剥器引导下分段结扎+属支Muller术治疗CVI，既可做到微创美观，又可保证手术的彻底性。

Abstract:

［Objective］ To investigate the therapeutic value of combined stepwise ligation of the great/small saphenous vein (GSV/CSV) guided by accurate marking and inversion stripping with muller's phlebectomy for superficial varicosis of lower limbs.［Methods］ There were 65 cases (72 lower limbs), among whom 61 limbs of GSV and 11 limbs of GSV/SSV were stepwisely ligated guided with accurate marking and inversion stripping, and all varicose branches were treated with muller hook. Venous clinical severity score (VCSS) were analyzed retrospectively.［Results］ After operation,there were 10 cases (11 limbs) that experienced temporary swelling, 1 case of incision infection, 1 case of residual varicosis and 1 case of compressive ulcer. All of them recovered after expectant treatment. The value of VCSS (1.5±0.3) in 90 days after operation decreased significantly (t=2.25, P≤0.05) when comparing with that (7.0±4.2) before operation.［Conclusions］ Stepwise ligation of GSV/CSV guided by accurate marking and inversion stripping with muller’s phlebectomy is microinvasive, esthetic and thorough to treat superficial varicosis of lower limbs.