Clinical Analysis of Venous Ulcer of Lower Limb Treated by Subfascial Endoscopic Perforating Vein Surgery (Report of 30 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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樊宝瑞 ¹ , 刘建夏 ¹ , 徐国雄 ² , 戴玮 ³ , 戴翔 ⁴

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Keywords：

下肢静脉功能不全; 静脉性溃疡; 腔镜深筋膜下交通支离断术; 深筋膜下; 交通支

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目的探讨腔镜深筋膜下交通支离断术（subfascial endoscopic perforating vein surgery，SEPS）治疗下肢静脉性溃疡的效果及优势。
方法对苏州大学附属第一医院2006年12月至2008年5月期间收治的30例下肢静脉性溃疡患者（32条患肢）实施SEPS。术后观察溃疡的愈合情况及其他症状的改善情况。
结果全组随访3～15个月（平均8.5个月），静脉性溃疡于术后27～103 d(平均65 d)内愈合，湿疹消失，色素沉着逐渐变浅；随访期间无切口感染等并发症，未见溃疡复发及新生溃疡。
结论 SEPS安全有效，损伤小，并发症少，是治疗下肢静脉性溃疡较为有效的方法。

Citation： 樊宝瑞,刘建夏,徐国雄,戴玮,戴翔. Clinical Analysis of Venous Ulcer of Lower Limb Treated by Subfascial Endoscopic Perforating Vein Surgery (Report of 30 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(5): 493-495. doi: Copy

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11.	张强, 王跃东. 电视内镜下静脉交通支断离术 [J]. 中国内镜杂志, 1998; 4(5): 20, 24.
12.	Kalra M, Gloviczki P. Surgical treatment of venous ulcers: role of subfascial endoscopic perforator vein ligation [J]. Surg Clin North Am, 2003; 83(3): 671-705.
13.	Delis KT, Ibegbuna V, Nicolaides AN, et al. Prevalence and distribution of incompetent perforating veins in chronic venous insufficiency [J]． J Vasc Surg, 1998; 28(5): 815-825.
14.	Tenbrook JA Jr, Iafrati MD, O’donnell TF Jr, et al. Systematic review of outcomes after surgical management of venous disease incorporating subfascial endoscopic perforator surgery [J]. J Vasc Surg, 2004; 39(3): 583-589.
15.	龙厚勇, 刘君, 郑启昌．股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全的疗效分析 [J]．中国普外基础与临床杂志, 2007； 14(3)： 335-336.

1. 张纪蔚, 张柏根. 下肢难治性静脉溃疡 [J]. 中国实用外科杂志, 2001; 21(5): 269-271.
2. 尹乐平, 冯超, 顾毅, 等. 肢静脉交通支腔镜下离断术(附57例报告) [J]. 中国普外基础与临床杂志, 2003; 10 (5): 485-486.
3. 张培华, 蒋米尔. 临床血管外科学 [M]. 第2版. 北京：科学出版社, 2007: 136. [４]Nelzén O. Prospective study of safety, patient satisfaction and leg ulcer healing following saphenous and subfascial endoscopic perforator surgery [J]. Br J Surg, 2000; 87(1): 86-91.
4. Linton RR. The communicating veins of the lower leg and the operative technic for their ligation [J]. Ann Surg, 1938; 107(4): 582-593.
5. Baron HC, Saber AA, Wayne M. Endoscopic subfascial surgery for incompetent perforator veins in patients with active venous ulceration [J]. Surg Endosc, 2001; 15(1): 38-40.
6. 葛巍，龙晓丹, 孙远旭, 等. 不同治疗方法对下肢慢性静脉溃疡的疗效分析 [J]. 现代医药卫生, 2008; 24(9): 1327.
7. Dodd H, Cockett FB. The pathology and Surgery of the veins of the lower limb [M]. 2nd ed. London: Churchill, 1976: 174.
8. Padberg FT Jr. Endoscopic subfascial perforating vein ligation: its complementary role in the surgical management of chronic venous insufficiency [J]. Ann Vasc Surg, 1999; 13(3): 343-354.
9. Pierik EG, van Urk H, Hop WC, et al. Endoscopic versus open subfascial division of incompetent perforating veins in the treatment of venous leg ulceration: a randomized trial [J]. J Vasc Surg, 1997; 26(6): 1049-1054.
10. Gloviczki P, Bergan JJ, Rhodes JM, et al. Mid-term results of endoscopic perforator vein interruption for chronic venous insufficiency: lessons learned from the North American subfascial endoscopic perforator surgery registry. The North American Study Group [J]. J Vasc Surg, 1999; 29(3): 489-502.
11. 张强, 王跃东. 电视内镜下静脉交通支断离术 [J]. 中国内镜杂志, 1998; 4(5): 20, 24.
12. Kalra M, Gloviczki P. Surgical treatment of venous ulcers: role of subfascial endoscopic perforator vein ligation [J]. Surg Clin North Am, 2003; 83(3): 671-705.
13. Delis KT, Ibegbuna V, Nicolaides AN, et al. Prevalence and distribution of incompetent perforating veins in chronic venous insufficiency [J]． J Vasc Surg, 1998; 28(5): 815-825.
14. Tenbrook JA Jr, Iafrati MD, O’donnell TF Jr, et al. Systematic review of outcomes after surgical management of venous disease incorporating subfascial endoscopic perforator surgery [J]. J Vasc Surg, 2004; 39(3): 583-589.
15. 龙厚勇, 刘君, 郑启昌．股浅静脉瓣膜环形缩窄术治疗原发性下肢深静脉瓣膜功能不全的疗效分析 [J]．中国普外基础与临床杂志, 2007； 14(3)： 335-336.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Analysis of Venous Ulcer of Lower Limb Treated by Subfascial Endoscopic Perforating Vein Surgery (Report of 30 Cases)

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