下肢靜脈病變順行造影及手術治療602例分析

1、下肢靜脈病變順行造影及于?術治療602例分析【關鍵詞】下肢靜脈病變【摘要】目的通過對640條下肢深靜脈順行造影及手術治療進行分析。方法1995年1月? 2002年12月，共行下肢靜脈順行造影602例共640條患肢，手術564條患肢。結果原發(fā) 性深靜脈功能不全427條(66.72%),行股淺靜脈第一瓣膜包窄術+人隱靜脈高位結扎抽剝 術427條(100%);深靜脈血栓形成后遺癥112條(17.5%),行大隱靜脈高位結扎抽剝術36 條(32.

2、1%);單純大隱靜脈曲張96條，行?大隱靜脈高位結扎抽剝術(100%);先天無瓣膜癥 2條(0.31%),行靜脈肌襟成形術，大隱靜脈高位結扎抽剝術(100%);先天靜脈畸形骨肥 大綜合征3條(0.47%),行淺表畸形靜脈切除術(100%)o結論 下肢靜脈順行造影是下肢 靜脈疾病診斷和鑒別診斷的可靠方法，為卜肢靜脈疾病手術提供了可靠依據(jù)。關鍵詞 下肢 靜脈造影術 手術vP style=uTEXT-INDENT: 24px“ align=

3、center>Clinical analysis of anterograde visualization and treatment ofpathosis of deep vein of lower limb in602casesYang Li, Xu Jun.Department of Surgery, Central Hospital of YangPu District, Shanghai, 2()0090.[Abstra

4、ct ] Objective To assess the value of anterograde visualization of deep vein of lower limb in the treat ~ me nt of lower limbs venous disease.Methods From January 1995to December2002, there were602cases, totally6401imbs

5、were carried out anterograde visualization of deep of lower limb, 5641imbs of those received surgical treat ~ ment.Results There were4271ower limbs (66.72%) with primary valvular insufficiency of deep vein, all these cas

6、es ( 100%) were taken external constriction valvuloplasty of superficial femoral vein, together with high ligation and strip ~ ping of great saphenous vein;l 121ower limbs (17.5%) with sequel ofthrombosis of deep vein, a

7、mong whom36cases (32.1%) received high ligation and stripping of great saphenous vein;961ower limbs with varicosity of great saphe 一 nous vein operated with high ligation and strippng of great saphenous vein;21owerlimbs

8、(0.31%) with congenital valveless were taken substitute valve operation and high ligation and stripping of great saphenous vein, and41ower limbs (0.47%) with congenital vein deformity and hyperostosis syndrome were all t

9、reated with stripping of varicose vein.Conclusion Deep vein visualization of lower limb is the most dependable method for diagnosis and differential diagnosis of lower limb venous disease, and provides reliable evidence

10、for the treatment of lower limbs venous disease.Key words lower limb vein visualization surgery下肢深靜脈順行造影術是日前診斷卜肢靜脈系統(tǒng)病變最簡單可靠的方法。我院自1995年1 刀?2002年12刀對602例計640條下肢施行深靜脈順行造影術，根據(jù)造彫結果運用不同的 手術方法取得了良好的效果，現(xiàn)將結果分析報告如下。1資料與方法1.1 一般資料

11、 本組602例中,男332例(占55.15%),女270例(占44.85%);年齡21?85 歲。病變在單側下肢者564例，雙下肢者38例。64()條下肢深靜脈順行造影術，其中左下 肢416條，右卜?肢224例;共施行手術564條下肢。1.2造影方法 具體操作步驟如下：(1)病人平臥于X線攝片機床上；(2)向近側方向穿刺患 者足背淺靜脈，少數(shù)不宜穿刺者，町作足背淺靜脈切開，向足趾端插管，注入30%泛影制 胺80ml; (3)將病人臥于3

12、0°呈頭高足低位，以延緩造影劑回流速度；(4)于足踝部扎止 2曲明，伊惠生，張培華.下肢深靜脈瓣膜包窄術環(huán)包材料的實驗研究.中華普通外科雜志， 1999, 14 （2） :107,3楊力，姜偉慶，徐軍.等?原發(fā)性深靜脈功能不全性股淺靜脈第一瓣膜包窄術臨床分析.中國 綜合臨床,2001, 17 （11） :875-876.4 Negus D.Venous return from the lower limb muscle pum