彩色多普勒超声引导无切口皮下缝扎大隐静脉治疗大隐静脉曲张

目的：探讨彩色多普勒超声引导下，无切口大隐静脉曲张手术的临床疗效。方法2011年12月～2013年12月，30例（37条患肢）单纯性大隐静脉曲张在彩色多普勒超声定位、引导下行大隐静脉主干高位皮下缝扎、分支曲张静脉及交通支静脉皮下缝扎。结果手术无切口。单侧手术时间17～42 min，中位时间28 min。术后住院2～5 d，中位时间3 d。30例（37条患肢）术后随访3～21个月，平均13．2月，无下肢疼痛，下肢迂曲、曲张静脉消失，溃疡愈合，色素沉着减轻，彩超检查大隐静脉主干闭合良好，无血流信号，深静脉通.，无血栓形成，2例局部复发，采用局麻，彩超精确定位、引导下皮下缝扎处理，治愈。结论彩色多普勒超声定位、引导下行大隐静脉主干高位皮下缝扎、分支曲张静脉及交通支静脉皮下缝扎疗效确切，无切口，美观，值得推广。

Ultrasound Guided Surgery Without Incision for Varicosis of Great Saphenous Veins

Objective To investigate the therapeutic effects of ultrasound guided surgery without incision in the treatment of great saphenous varicose veins . Methods Ultrasound guided surgery without incision was performed in 30 cases of varicose great saphenous veins （37 limbs） from December 2011 to December 2013.Under the guidance of ultrasonography , the great saphenous vein stem, branch, and communicating branch were intracutaneously suture ligated respectively . Results All the operation were performed without incision .The operation time was 17-42 min （ median, 28 min） .Postoperative hospital stay ranged from 2 to 5 days （median, 3 days）.All the patients were followed up for 3-21 months with a mean of 13.2 months.The symptoms of the 30 cases after the surgery relieved significantly .The local skin malnutrition atrophy was relieved gradually and the venous varicosis disappeared completely.There were 2 cases of recurrence , who were cured by ultrasound guided intracutaneous suture ligation of communicating branch under local anesthesia . Conclusion Ultrasound guided surgery without incision is a safe , effective , and minimally invasive procedure for great saphenous varicose veins , being worthy of recommendation .