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止血带辅助下点式剥脱术治疗原发性大隐静脉曲张

【摘要】 目的 探讨止血带、驱血带辅助下大隐静脉高位结扎点式剥脱术治疗大隐静脉曲张的效果。方法止血带、驱血带辅助下采用大隐静脉高位结扎点式剥脱术治疗大隐静脉曲张病人126例共156条患肢。结果 单侧患肢手术时间55~90 min,平均(60±10) min;术中出血5~15 mL,平均(10±3)mL;术后6 h均能下床活动,曲张静脉全部消失;腹股沟Ⅰ类切口均一期甲级愈合,其中6条(3.8%)患肢术后当天切口有少量渗血, 8条(5.1%)患肢术后出现小腿内侧皮下血肿,于3~6个月内吸收软化。 10条(6.4%)患肢术后出现足靴区麻木感,均于6个月内麻木感消失。126例病人获随访110例129条患肢,随访率为87.3%。随访时间3~15个月,平均8个月,疗效满意。结论 止血带、驱血带辅助下大隐静脉高位结扎点式剥脱手术操作简单,手术时间短,出血少,易于掌握,且疗效理想,值得推广。

  【关键词】 静脉曲张;下肢;外科手术;止血带

  POINTFORMSTRIPPING IN THE TREATMENT OF PRIMARY VARICOSITY OF GREAT SAPHENOUS VEIN WITH THE AID OF TOURNIQUET DIAO XINQING, SONG FUBO, YANG MU, et al (Department of Vascular Surgery, People’s Hospital of Qixia, Qixia 265300, China); [ABSTRACT] Objective To assess the efficacy of the treatment of varicosity of great saphenous vein (GSV) using high ligation of GSV and pointformstripping (PFS) with the aid of tourniquet. Methods High ligation of GSV combined with PFS with the assist of tourniquet and exsanguination was performed in 126 patients (156 affected limbs). Results The mean (range) operative duration of unilateral limb was 60±10 (55-90) min; mean (range) blood loss was 10±3 (5-15) mL, outofbed time was six hours postoperatively, varicose veins disappeared in all cases. GradeA healing was obtained in class1 incisions, in which, six limbs (3.8%) had a small amounts of hematopedesis the day of surgery; eight limbs (5.1%) experienced ecchymoma in medial part of the leg that were absorbed and softened in 3-6 months. Insensible feeling was noted in footwear site in 10(6.4%) limbs, which disappeared within six months. A followup was available in 110 cases (126 affected limbs), with followup rate being87.3%. The mean (range) followup was eight (3-15) months with a satisfied effectiveness. Conclusion The procedure of high ligation of GSV combined with PFS with the assist of tourniquet and exsanguination is simple, timesaving, less bleeding, easy to master and with an ideal curative effect.

  [KEY WORDS] vari

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