超声在泡沫硬化剂闭合交通静脉治疗下肢静脉性溃疡中的作用

目的 探讨彩色多普勒超声在泡沫硬化剂闭合交通静脉治疗下肢静脉性溃疡中的作用.方法 选择2014年12月-2016年8月在重庆医科大学附属第一医院血管外科接受超声引导下泡沫硬化剂闭合小腿病变交通静脉的静脉性溃疡患者(C6期),观察术后皮肤溃疡的愈合情况并通过彩色多普勒超声对静脉闭合情况进行随访.结果 114例患者共119条患肢(C6期)接受治疗,术前超声检查证实均存在小腿交通静脉病变(1～3支).平均闭合小腿交通静脉2.1条(1～3条).术后平均随访11.3个月(1～21个月),术后1个月溃疡愈合率为100％,病变交通支闭塞率为100％;随访期间,溃疡复发3例(3条患肢),病变交通静脉再通8支.未出现严重并发症.结论 彩色多普勒超声能提高泡沫硬化剂闭合小腿交通静脉治疗下肢静脉性溃疡的疗效和安全性,具有较高的临床实用价值.

Effect of Doppler ultrasound in the treatment of venous leg ulcer by foam sclerotherapy for perforating veins closure

Objective To evaluate the clinical effects of color Doppler ultrasound in perforating vein closure by foam sclerotherapy for the treatment of venous leg ulcer.Methods Choosing the patients with venous ulcers (classified as C6) that underwent superficial and perforating veins closure by ultrasound-guided foam sclerotherapy in the Department of Vascular Surgery,First Affiliated Hospital of Chongqing Medical University,during December 2014 to August 2016.All patients were followed up by color Doppler scanning for veins closure,and the postoperative healing of skin ulcers were observed at the same time.Results A total of 114 patients with 119 limbs were enrolled,which were confirmed 1-3 perforating vein lesions by ultrasound.An average of 2.1 perforators were closed per leg (1-3 perforators).The average follow-up period was 11.3 months (1-21 months).The healing rate is 100％ and all the insufficient perforating veins were occlusion 1 month postoperative.Three cases of ulcer recurrence,and 8 cases of insufficient perforator recanalization were found.Serious complications did not appear.Conclusions Color doppler ultrasound can improve the safety and efficacy of perforating vein closure by foam sclerotherapy for the treatment of venous leg ulcer,and it has a high clinical value.