改良手术治疗大隐静脉曲张的临床疗效。

Q4 Medicine Journal of Chest Surgery Pub Date : 2023-11-05 Epub Date: 2023-10-11 DOI:10.5090/jcs.23.098
Ki Pyo Hong
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摘要

背景:本研究的目的是评估改良手术治疗静脉曲张的临床疗效。方法:对2015年1月至2022年4月期间有症状的大隐静脉(GSV)功能不全的下肢进行回顾性分析,这些下肢接受了从腹股沟到膝盖的剥离,并保留了上腹部浅静脉(SEV)。术后6个月和12个月使用多普勒超声、静脉临床严重程度评分(VCSS)和阿伯丁静脉曲张问卷(AVVQ)进行随访评估。结果:该研究包括120名患者(47名男性和73名女性)的179条肢体。平均患者年龄为56.5岁(范围为20-78岁),术前临床病因解剖病理生理学临床分类的分布为8%C0-C1、88%C2和4%C3-C6。术前隐股汇合处的平均直径为6.9 mm(范围为2.7-15.8 mm)。术后平均随访24个月后,在2条肢体(1.1%)中观察到隐股交界处(SFJ)残端周围有新生血管的迹象。此外,在1条肢体(0.6%)中发现静脉曲张复发,并与大腿穿支器功能不全有关。术后随访时,VCSS和AVVQ评分均显著低于术前评分。结论:GSV功能不全的改良手术治疗,包括保留SEV和剥离膝盖以下的一小段,在术后并发症发生率、SFJ残端周围新生血管形成率、静脉曲张复发率和下肢症状改善方面取得了良好的临床效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Clinical Efficacy of a Modified Surgical Procedure in the Treatment of Incompetent Great Saphenous Veins.

Background: The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins.

Methods: This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery.

Results: The study included 179 limbs from 120 patients (47 men and 73 women). The mean patient age was 56.5 years (range, 20-78 years), and the distribution of preoperative Clinical-Etiology-Anatomy-Pathophysiology clinical classes was 8% C0-C1, 88% C2, and 4% C3-C6. The preoperative diameter of the saphenofemoral confluence averaged 6.9 mm (range, 2.7-15.8 mm). After a mean postoperative follow-up period of 24 months, evidence of neovascularization around the stump of the saphenofemoral junction (SFJ) was observed in 2 limbs (1.1%). Additionally, varicose vein recurrence was found in 1 limb (0.6%) and was associated with an incompetent thigh perforator. At postoperative follow- up, both VCSS and AVVQ scores were significantly lower than the preoperative scores.

Conclusion: Modified surgical treatment of GSV incompetence, involving preservation of the SEV and stripping of a short segment up to the knee, demonstrated favorable clinical results in terms of postoperative complication rate, neovascularization rate around the SFJ stump, varicose vein recurrence rate, and improvement in lower extremity symptoms.

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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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