Clinical Analysis of Individual Therapy for 360 Patients with Venous Ulceration of Lower Extremity_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LILiang ¹ , ZHUXiao-ming ¹ ,  TANGXiao-yong ¹ , SHeNGLi ²

1. Department of General Surgery, Gansu Province Hospital of TCM, Lanzhou 730050, Gansu Province, China;
2. Department of Ultrasound, Gansu Province Hospital of TCM, Lanzhou 730050, Gansu Province, China;

Corresponding author：

TANGXiao-yong, Email: 1351281436@qq.com

Keywords：

Varicose veins of lower extremity; Venous ulceration; Individual therapy

DOI：

10.7507/1007-9424.20160158

Video：

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Objective To evaluate feasibility and clinical effect of individual therapy for venous ulceration of lower extremity. Methods From February 2012 to February 2014, 360 cases (totally 421 lower limbs) treated by the individual therapy were analyzed retrospectively. There were 126 male and 234 female patients, with a mean age of 53 years (ranging from 45 to 78 years). The venous ulceration occurred in left limb for 176 cases, right limb for 123 cases, and both limbs for 61 cases. The individualized treatment plans were performed for all the patients according to the color Doppler before the operation. The perforating vein was ligated during the operation, and elastic stockings were wore after operation. The operation time, postoperative VAS pain score, perioperative complications, ulcer healing and recurrence were recorded. Results The operations were completed in all the patients, the average operation time was 35 min. The average VAS pain score was 2.6 at 8 h after operation, the pain was disappeared nearly at 24 h after operation. The time of returning to normal activity was 3 d. The incision bleeding occurred in 5 cases, the ulcer infection occurred in 32 lower limbs. The patients were followed-up for 12 months to 24 months, all the ulcers were healed, there were 9 cases of recurrence. Conclusion Individual therapy for venous ulceration of lower extremity is safe, effective, fewer complications, fast ulcer healing, and less postoperative pain.

Citation： LILiang, ZHUXiao-ming, TANGXiao-yong, SHeNGLi. Clinical Analysis of Individual Therapy for 360 Patients with Venous Ulceration of Lower Extremity. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(5): 590-593. doi: 10.7507/1007-9424.20160158 Copy

1.	张纪蔚, 张柏根.下肢难治性静脉溃疡.中国实用外科杂志, 2001, 21(5):269-271.
2.	2赵东红, 陈存富.下肢溃疡的病因及治疗概况.实用医药杂志, 2010, 27(2):171-173.
3.	常光其, 殷恒讳, 李晓曦, 等.复发性静脉性溃疡的原因分析及再处理方法.中华外科杂志, 2011, 49(6):500-502.
4.	Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases:clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg, 2011, 53(5):2S-48S.
5.	吴庆华, 张煜亚.推广普及CEAP分级法在我国血管外科的临床应用.中华普通外科杂志, 2008, 23(3):164-167.
6.	谷涌泉, 张建.下肢血管外科.北京:人民卫生出版社, 2010:234.
7.	陈光勇, 黄维, 林洪山, 等.彩色多普勒超声在大隐静脉曲张术前的应用.中国医学影像学杂志, 2007, 15(4):309-310.
8.	陈琉, 常李, 陈金鳌.下肢慢性静脉性溃疡病因学及治疗研究.中国普通外科杂志, 2012, 21(6):717-720.
9.	Bergan JJ, Schmid-Schönbein GW, Smith PD, et al. Chronic venous disease. N Engl J Med, 2006, 355(5):488-498.
10.	Raffetto JD. Dermal pathology, cellular biology, and inflammation in chronic venous disease. Thromb Res, 2009, 123(Suppl 4):S66-S71.
11.	Claudy AL, Mirshahim M, Soria C, et al. Detection of undegraded fibrin and tumor necrosis factor-alpha in venous leg ulcers. J Am Acad Dermatol, 1991, 25(4):623-627.
12.	王昆, 乔正荣, 时德.腓肠肌泵与下肢慢性静脉功能不全.中国普外基础与临床杂志, 2002, 9(1):53-55.
13.	Recek C. Venous pressure gradients in the lower extremity and the hemodynamic consequences. Vasa, 2010, 39(4):292-297.
14.	Donaldson MC. Chronic venous indufficiency. Curr Treat Options Cardiovasc Med, 2000, 2(3):265-272.
15.	林海.腔镜深筋膜下小腿交通静脉断离术的临床应用.中国医师进修杂志, 2006, 29(10B):40-41.
16.	Ratiu A, Navolan D, Spatariu L, et al. Diagnostic value of a negative single color duplex ultrasound in deep vein thrombosis suspicion during pregnancy. Rev Med Chir Soc Med Nat Iasi, 2010, 114(2):454-456.
17.	Dauzet M, Laroche JP, Deklunder G, et al. Diagnosis of acute lower limb deep venous thrombosis with ultrasound:trends and controversies. J Clin Ultrasound, 1997, 25(7):343-358.
18.	Neglen P, Raju S. A comparison between descending phlebography and duplex Doppler investigation in the evaluation of reflux in chronic venous insufficiency:a challenge to phlebography as the "gold standard". J Vasc Surg, 1992, 16(5):687-693.

1. 张纪蔚, 张柏根.下肢难治性静脉溃疡.中国实用外科杂志, 2001, 21(5):269-271.
2. 2赵东红, 陈存富.下肢溃疡的病因及治疗概况.实用医药杂志, 2010, 27(2):171-173.
3. 常光其, 殷恒讳, 李晓曦, 等.复发性静脉性溃疡的原因分析及再处理方法.中华外科杂志, 2011, 49(6):500-502.
4. Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases:clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg, 2011, 53(5):2S-48S.
5. 吴庆华, 张煜亚.推广普及CEAP分级法在我国血管外科的临床应用.中华普通外科杂志, 2008, 23(3):164-167.
6. 谷涌泉, 张建.下肢血管外科.北京:人民卫生出版社, 2010:234.
7. 陈光勇, 黄维, 林洪山, 等.彩色多普勒超声在大隐静脉曲张术前的应用.中国医学影像学杂志, 2007, 15(4):309-310.
8. 陈琉, 常李, 陈金鳌.下肢慢性静脉性溃疡病因学及治疗研究.中国普通外科杂志, 2012, 21(6):717-720.
9. Bergan JJ, Schmid-Schönbein GW, Smith PD, et al. Chronic venous disease. N Engl J Med, 2006, 355(5):488-498.
10. Raffetto JD. Dermal pathology, cellular biology, and inflammation in chronic venous disease. Thromb Res, 2009, 123(Suppl 4):S66-S71.
11. Claudy AL, Mirshahim M, Soria C, et al. Detection of undegraded fibrin and tumor necrosis factor-alpha in venous leg ulcers. J Am Acad Dermatol, 1991, 25(4):623-627.
12. 王昆, 乔正荣, 时德.腓肠肌泵与下肢慢性静脉功能不全.中国普外基础与临床杂志, 2002, 9(1):53-55.
13. Recek C. Venous pressure gradients in the lower extremity and the hemodynamic consequences. Vasa, 2010, 39(4):292-297.
14. Donaldson MC. Chronic venous indufficiency. Curr Treat Options Cardiovasc Med, 2000, 2(3):265-272.
15. 林海.腔镜深筋膜下小腿交通静脉断离术的临床应用.中国医师进修杂志, 2006, 29(10B):40-41.
16. Ratiu A, Navolan D, Spatariu L, et al. Diagnostic value of a negative single color duplex ultrasound in deep vein thrombosis suspicion during pregnancy. Rev Med Chir Soc Med Nat Iasi, 2010, 114(2):454-456.
17. Dauzet M, Laroche JP, Deklunder G, et al. Diagnosis of acute lower limb deep venous thrombosis with ultrasound:trends and controversies. J Clin Ultrasound, 1997, 25(7):343-358.
18. Neglen P, Raju S. A comparison between descending phlebography and duplex Doppler investigation in the evaluation of reflux in chronic venous insufficiency:a challenge to phlebography as the "gold standard". J Vasc Surg, 1992, 16(5):687-693.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Analysis of Individual Therapy for 360 Patients with Venous Ulceration of Lower Extremity

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