陈宝?曾维?谭健新?黄振钦?刘国权

[摘要] 目的 研究雙下肢静脉曲张单侧术后对对侧下肢静脉血流动力学的影响。 方法 对我院84例原发性双下肢静脉曲张老年患者进行研究，随机均分为两组，B组对严重一侧肢体行手术治疗，A组予以双侧手术，比较手术前后两组下肢静脉血流速度、症状改善情况。 结果 A组病情较轻侧浅静脉血流速度术后得到明显改善，B组术后6个月开始明显改善（P<0.05）；两组术后12个月双下肢深静脉血流速度比较差异并不显著，且术后6、12个月病情较轻侧浅静脉血流速度比较差异并不显著（P>0.05）；术后12个月，两组双下肢疼痛程度、乏力程度、色素沉着以及静脉迂曲程度比较无明显差异（P>0.05）；B组25例（60.98%）不用行手术治疗。 结论 双下肢静脉曲张单侧术后，对侧下肢静脉血流速度、疼痛、乏力、色素沉着以及静脉迂曲等症状也会得到改善，可在一定程度上降低对侧下肢需手术率。

[关键词] 双下肢；静脉曲张；单侧术；静脉血流动力学；影响

[中图分类号] R654.4 [文献标识码] A [文章编号] 2095-0616（2017）09-179-03

Clinical research and effect of unilateral surgery for varicose veins of both lower limbs on venous hemodynamics of contralateral lower limb

CHEN Bao ZENG Wei TAN Jianxin HUANG Zhenqin LIU Guoquan

Jiangmen Xinhui District People's Hospital， Jiangmen 529100， China

[Abstract] Objective To study the effect of unilateral surgery for varicose veins of both lower limbs on venous hemodynamics of contralateral lower limb. Methods 84 elderly patients with primary varicose veins of both lower limbs in our hospital were researched and they were randomly divided into two groups. Group B was treated with unilateral surgery for the serious limb while group A were treated with bilateral surgery. The venous flow velocity of lower limbs and improvements of symptoms before and after operation of two groups were compared. Results The superficial venous blood flow velocity of milder limbs of group A was significantly improved after surgery， while that of group B was significantly improved at 6 months after surgery （P<0.05）. Differences in deep venous blood flow velocity of both limbs of 12 months after surgery of two groups were not significant. And differences in superficial venous blood flow velocity of milder limbs of 6 months and 12 months after surgery of two groups were not significant （P>0.05）. 12 months after surgery， there was no significant difference in pain degree of both lower limbs， degree of weakness， pigmentation and degree of venous tortuosity between two groups （P>0.05）. 25 patients in group B didnt need to accept surgical treatment， accounting for 60.89%. Conclusion After unilateral surgery for varicose veins of both lower limbs， venous blood flow velocity， pain， weakness， pigmentation， venous tortuosity and other symptoms of contralateral lower limb were improved， which can reduce the surgical rate of the contralateral lower limb to a certain extend.

[Key words] Both lower limbs； Varicose veins； Unilateral surgery； Hemodynamics； Effect

原发性下肢深静脉瓣膜功能不全（PDVI）和下肢浅静脉曲张存在紧密联系，通常情况下是同时存在的，下肢浅静脉曲张主要病因之一就是PDVI。临床上，一般对静脉曲张患者实施剥脱术联合高位结扎术方案进行治疗，并取得了良好疗效。医学常识的缺乏，导致农村地区大部分老年下肢静脉曲张患

者未得到及時诊治，而这部分患者常为双侧下肢病变，且患病时间长，症状重，合并内科疾病多，若手术时同时施行两侧，手术风险高。现阶段，国内文献鲜有提及若为双侧病变患者，是两侧同时施行，或每侧肢体分期实行手术治疗，且具体时间间隔多少为合适亦有疑问[1-2]。本……