文档介绍：1 静脉腔内激光联合手术治疗下肢静脉曲张作者:刘咸罗柳小刚汤永胜钱小星陈克辉胡开兵徐晓峰【摘要】目的初步评价腔内激光联合手术治疗下肢静脉曲张的疗效。方法全组下肢静脉曲张患者 28例,共38 条下肢。按病因和病情的不同,采用 3 种手术治疗:(1)临床表现明显的原发性下肢深静脉瓣膜功能不全者 4 条下肢, 作股浅静脉瓣膜包窄+ 大隐静脉高位结扎+EVLT+SEPS 术; (2) 轻度原发性深静脉瓣膜功能不全者 15 条下肢, 作大隐静脉高位结扎+EVLT+SEPS ;(3) 单纯性大隐静脉曲张者 19 条下肢, 作大隐静脉高位结扎+EVLT 。结果平均随访 11个月, 全组患者均无复发; 临床症状和体征消退或好转, 彩超检查示大隐静脉均全程闭合, 无血流信号。结论 EVLT 具有无创、安全、操作简便和疗效良好的优点, 联合手术治疗下肢静脉病变的效果满意。【关键词】静脉腔内激光治疗; 下肢静脉曲张; 瓣膜重建术 Preliminary report on efficacy of EVLT used bination with surgery in the treatment of venous disease in 2 lower limbs 【 Abstract 】 Objective To evaluate the preliminary results of EVLT bination with surgery in treating venous disease of lower Twenty-Eight patients with a total of 38 disease lower limbs underwent EVLT with itant therapeutic entities were included :① severe primary reflux of the deep vEIns (4 limbs) : EVLT+external banding valvuloplasty of superficial femoral vein+high-ligation at the saphenofemoral junction+SEPS ;② mild primary reflux of the deep veins (15 limbs) : EVLT+high-ligation of saphonofemoral junction+SEPS ;③ simple saphenous varicosity (19 limbs):EVLT+high-ligation of great saphenous All patients were followed up with a mean of 11 months with satisfactory EVLT bination with surgery isa new therapeutic entity possessing advantages of safety,easy-performance,minimal invasiveness and good results. 【 Key words 】 endovenous laser therapy;lower limb varicosity;valvular reconstructive operation 下肢浅静脉曲张是外科常见病,可由多种不同的病因引 3 起。除单纯性大隐静脉曲张外, 都应查明病因, 然后在针对致病原因进行适当手术治疗的同时,作大隐静脉高位结扎+ 剥脱术+ 曲张浅静脉分支切除和交通静脉结扎等。近年来, 随着微创技术的发展,使静脉腔内激光治疗( endovenous laser treatment,EVLT )成为现实,进一步提高手术疗效。我院于 2004 年2月~2005 年5月, 采用 EVLT 联合手术治疗下肢静脉曲张 28 例(共 38 条下肢) ,取得满意效果,现报告如下。 1 临床资料 一般资料全组 28 例中,男 16例,女 12例;年龄 27~75 岁,平均 岁;病程 5~40 岁,平均 岁;左下肢 16 条,右下肢 12 条,双下肢 5 例( 10 条下肢) ,共有患肢 38条。主要临床表现为患肢浅静脉曲张( 38条, 100% ); 肿胀( 30 条, % ) ;胀痛或沉重感( 26 条, % ) ;小腿下段营养障碍性病变, 包括皮炎、湿疹、色素沉着等(17 条, % ) 。全组 28 例均无下肢深静脉血栓形成