摘要
大隐静脉(GSV)或小隐静脉(SSV)高位结扎剥脱术结合浅静脉曲张切除术是下肢浅静脉曲张的标准治疗方法。神经损伤、深静脉血栓形成(DVT)、出血、血肿及感染等剥脱术所致的并发症均可引起术后正常活动恢复的延迟。随着医学技术的进步,血管腔内治疗技术在静脉曲张治疗中的应用日益广泛。基于静脉血流动力学分析治疗下肢浅静脉曲张的保留GSV的血流改道手术(CHIVA)是一种保留静脉引流网络的治疗方法。血管内泡沫硬化疗法是全球范围内广泛使用的浅静脉反流治疗技术,超声引导提高了其安全性和有效性。下肢浅静脉点状剥脱术通过小切口切除曲张静脉,既往与GSV或SSV高位结扎剥脱术同时进行,目前通常与GSV腔内消融术同时进行。本文就下肢浅静脉曲张的治疗现状进行综述。
High saphenous ligation and stripping of great saphenous vein(GSV)or small saphenous vein(SSV)combined with the resection of superficial varicose veins is the standard treatment for superficial varicose veins of lower extremity.The complications caused by stripping include nerve injury,deep venous thrombosis(DVT),bleeding,hematoma,and infection,which can delay the recovery of normal postoperative activities.Due to the advancement of medical technology,endovascular treatment has been widely used in treatment of varicose veins.Conservatrice et hémodynamique de l’insuffisance veineuse en ambulatoire(CHIVA)treatment of superficial lower extremity varicose veins based on venous hemodynamic analysis is a treatment method that preserves venous drainage network.Endovascular foam sclerotherapy is a widely used technique throughout the world for the management of superficial venous reflux and ultrasound guidance improves its safety and efficacy.Stab phlebectomy is a method that remove varicose veins through small stab wounds,which was performed in conjunction with saphenous vein ligation and stripping of GSV or SSV in the past,and currently performed with endovascular ablation of GSV.This article reviews the current treatment status of superficial lower extremity varicose veins.
作者
李晓
陆清声
Li Xiao;Lu Qingsheng(Department of Vascular Surgery,the First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)
出处
《血管与腔内血管外科杂志》
2023年第1期59-69,83,M0002,共13页
Journal of Vascular and Endovascular Surgery
基金
国家自然科学基金(82270510)。
关键词
高位结扎剥脱术
浅静脉曲张
静脉切除术
腔内热消融
硬化剂
high ligation and stripping
superficial varicose vein
phlebectomy
endovascular thermal ablation
sclerotherapy
