天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (4): 385-388.doi: 10.11958/20160766

• 临床研究 • 上一篇    下一篇

腘静脉嵌压综合征 57 例临床分析

王国华 1， 陈学明 2， 陈智年 1△， 肖影 1， 张俊景 3   

  1. 1 新乡市中心医院血管外科 （邮编 453000）； 2 首都医科大学附属北京友谊医院血管外科； 3 新乡医学院三全学院
  • 收稿日期:2016-08-04 修回日期:2017-03-03 出版日期:2017-04-15 发布日期:2017-04-15
  • 通讯作者: △通讯作者 E-mail: zxyypwek@163.com E-mail:zxyypwek@163.com
  • 作者简介:王国华 （1979）， 男， 主治医师， 硕士， 主要从事血管外科及腔内血管的治疗方面研究
  • 基金资助:
    河南省科技攻关项目 （152102310211）

Clinical analysis of 57 patients with popliteal venous entrapment syndrome

WANG Guo-hua1, CHEN Xue-ming2, CHEN Zhi-nian1△, XIAO Ying1, ZHANG Jun-jing3   

  1. 1 Department of Vascular Surgery, Xinxiang Central Hospital, Xinxiang 453000, China; 2 Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University; 3 Sanquan College of Xinxiang Medical University △
  • Received:2016-08-04 Revised:2017-03-03 Published:2017-04-15 Online:2017-04-15
  • Contact: △Corresponding Author E-mail: zxyypwek@163.com E-mail:zxyypwek@163.com

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摘要： 目的 总结腘静脉嵌压综合征 （PVES） 的诊治经验。方法 选取 2009 年 3 月—2015 年 10 月间我院血管 外科收治的 PVES 患者 57 例。其中腘静脉重度狭窄（狭窄程度>90%）者 43 例， 14 例狭窄程度≤90%。所有患者入 院后行下肢静脉顺行造影检查， 确定临床分型。43 例重度狭窄患者采用腘静脉嵌压松解+曲张静脉剥脱术治疗， 测 量手术前后腘静脉静态压、 动态压和足背静脉静态压、 动态压； 另外 14 例采用医用循环驱动袜加口服药物进行保守 治疗。结果 所有患者腘静脉狭窄程度均在 75%以上。根据狭窄部位不同， 分为膝上型 9 例， 膝型 18 例， 膝下型 30 例。43 例手术治疗患者术后下肢肿胀、 疼痛缓解， 溃疡愈合， 影像学检查示腘静脉无明显受压、 狭窄， 血管充盈良好； 腘静脉和足背静脉的静态压和动态压均较术前下降 （P < 0.05）。保守治疗的 14 例患者下肢肿胀、 酸痛不适均缓解， 下肢静脉曲张未再继续加重。结论 PVES 较易误诊， 应引起重视， 症状严重者行腘静脉嵌压松解术联合曲张静脉 剥脱术可取得满意的临床效果。

关键词: 腘静脉, 诊断, 腘静脉嵌压综合征, 手术治疗

Abstract: Objective To summarize the experience in diagnosis and treatment of popliteal vein entrapment syndrome (PVES). Methods A total of 57 patients with PVES were selected from the Department of Vascular Surgery in Xinxiang Central Hospital from March 2009 to October 2015. Of which 43 patients were severe stenosis of popliteal vein (stenosis degree >90%), and another 14 cases were with stenosis less than 90%. All the patients underwent ascending venography of low limb to confirm the clinical classification after admission. Forty-three cases with severe stenosis of the popliteal vein were treated with releasing popliteal vein of entrapment and stripping varicose veins. The static pressure and dynamic pressure of popliteal vein and foot dorsal vein were measured before and after operation. Another 14 patients were treated with medical circulation driven sock and medical therapy. Results The degrees of popliteal vein stenosis were more than 75% in all patients. The patients were divided into bove- knee stenosis (n=9), knee stenosis (n=18), and below- knee stenosis (n=30) according to the different parts of stenosis. Forty- three patients treated with surgery showed relief of leg swelling and pain, and ulcer healing. And the imaging examination showed that there were no obvious compression and stenosis of popliteal vein, and vascular filling was well. The static pressure and dynamic pressure of the popliteal vein and dorsal vein were lower than those before surgery (P < 0.05). The lower limb swelling and pain were relieved, and varicose veins of lower limbs were no longer continued to increase in 14 patients with conservative treatment. Conclusion PVES is easy to be misdiagnosed, which should be paid attention to, and satisfactory clinical results can be achieved by releasing popliteal vein of compression combined with stripping varicose veins in patients with serious symptoms ．

Key words: popliteal vein, diagnosis, popliteal vein emtrapment syndrome, surgical treatment