本文選題：下肢靜脈　切入點：靜脈瓣膜　出處：《重慶醫(yī)科大學(xué)》2008年碩士論文　論文類型：學(xué)位論文

【摘要】： 第一部分下肢主要靜脈瓣膜的應(yīng)用解剖學(xué)研究 目的:通過對150側(cè)成年尸體下肢主要靜脈瓣膜的解剖觀察,為臨床手術(shù)治療提供解剖形態(tài)學(xué)參考。 方法:在150側(cè)成人下肢中,觀察、測量并分析大隱靜脈、股靜脈和乆靜脈的瓣膜數(shù)量和形狀、特別點外徑以及某些重要的鄰近結(jié)構(gòu)關(guān)系。 結(jié)果:大隱靜脈的瓣膜數(shù)目為4～15個,平均為7.2個;股靜脈瓣膜數(shù)量為1～6個,其中以3～4個多見,平均瓣膜數(shù)為3.3個;乆靜脈瓣膜數(shù)量為0～5個,其中,以1～2個多見,有3側(cè)肢體無乆靜脈瓣膜,平均瓣膜數(shù)為1.8個。股淺靜脈第一對瓣膜位置較為恒定,到隱股點距離為(5.45±1.32)cm。大隱靜脈、股靜脈和乆靜脈瓣膜以雙瓣型多見,瓣膜分布有越向遠(yuǎn)側(cè)越多的規(guī)律。 結(jié)論:以上對下肢靜脈的觀測結(jié)果,為臨床有關(guān)下肢靜脈的手術(shù)、操作提供了較為系統(tǒng)、全面的解剖學(xué)基礎(chǔ)。 第二部分原發(fā)性下肢深靜脈瓣膜功能不全的手術(shù)治療分析 目的:觀察并分析三種常見的深靜脈瓣膜重建術(shù)治療原發(fā)性下肢深靜脈瓣膜功能不全(PDVI)的手術(shù)療效。 方法:2005年7月至2007年12月期間我科收治的經(jīng)下肢順、逆行深靜脈造影,確診為PDVI的28例患者(36條患肢),根據(jù)癥狀輕重,采用大隱靜脈高位結(jié)扎及曲張靜脈剝脫術(shù)、瓣膜環(huán)縮戴戒術(shù)、腔內(nèi)深靜脈瓣膜修復(fù)術(shù)以及帶瓣靜脈段移植術(shù)進(jìn)行手術(shù)治療。用彩色多普勒血管超聲檢查、CEAP臨床分級和臨床記分評價所有患肢手術(shù)前后的情況,并進(jìn)行統(tǒng)計學(xué)分析。 結(jié)果:36條患肢術(shù)后的臨床分級和臨床記分均有明顯下降,全部患肢手術(shù)前、后的臨床記分分別為(6.2±3.1)、(2.1±1.5),差異有統(tǒng)計學(xué)意義(P 0.01)。12條C2～C3級患肢手術(shù)前、后的CEAP臨床記分為(2.2±1.1)、(1.1±0.7),有顯著性差異(P 0.05)。 結(jié)論:深靜脈瓣膜腔內(nèi)修復(fù)術(shù)、瓣膜環(huán)縮戴戒術(shù)和帶瓣靜脈段移植術(shù)對PDVI的療效良好。對癥狀較輕的C2～C3級患肢可單純采用大隱靜脈高位結(jié)扎、曲張靜脈剝脫術(shù)。
[Abstract]:Part I: applied anatomy of the main venous valves of the lower extremities. Objective: to provide anatomic morphological reference for surgical treatment of 150 adult cadavers with main venous valves of lower extremities. Methods: the number and shape of valves of great saphenous vein, femoral vein and human vein were observed, measured and analyzed in 150 sides of adult lower limbs, especially the external diameter of point and some important adjacent structures. Results: the valvular number of great saphenous vein was 4 ~ 15 with an average of 7.2, the number of femoral vein valves was 1 ~ 6, of which 3 ~ 4 were more, the average number of valves was 3.3, and the number of valves of vein was 0 ~ 5, of which 1 ~ 2 was more than 1 ~ 2. The average number of valves was 1.8. The position of the first pair of valves in superficial femoral vein was relatively constant, and the distance to the point of saphenous was 5.45 鹵1.32 cm 路cm. The valve of great saphenous vein, femoral vein and human vein were mostly double-valved. The distribution of valves is more and more in the distal direction. Conclusion: the observation results of the lower extremity veins provide a systematic and comprehensive anatomical basis for the operation of the lower extremity veins. The second part: surgical treatment of primary deep venous valve insufficiency of lower extremity. Objective: to observe and analyze the curative effect of three kinds of common deep vein valve reconstruction in the treatment of primary lower extremity deep vein valve insufficiency (PDVI). Methods: from July 2005 to December 2007, 28 patients with PDVI diagnosed by retrograde and retrograde deep vein angiography were treated with high ligation of great saphenous vein and exfoliation of varicose vein according to the severity of symptoms. Valvular ring ring, deep vena cava prosthesis and valvular segment transplantation were performed. The clinical grade and clinical score of CEAP were evaluated by color Doppler ultrasound before and after the operation of all affected limbs. Statistical analysis was carried out. Results the clinical grade and clinical score of 36 affected limbs decreased significantly after operation. Before and after the operation, the clinical scores were 6.2 鹵3.1 and 2.1 鹵1.5, respectively. The difference was statistically significant before and after the operation of C _ 2C _ 3 grade. The clinical score of CEAP was 2.2 鹵1.1 鹵0.7, with significant difference (P 0.05). Conclusion: deep vein valve repair, valvular ring ring ring repair and valvular vein segment transplantation have good effect on PDVI. High ligation of great saphenous vein and exfoliation of varicose vein can be used only for C _ 2C _ 3 grade patients with mild symptoms.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R322;R654.3

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前2條

1 崔凱;下肢靜脈及其瓣膜的解剖學(xué)研究及在介入治療下肢靜脈曲張中的應(yīng)用[D];天津醫(yī)科大學(xué);2010年

2 馬艷鋒;外洗法治療下肢深靜脈炎的療效觀察[D];廣州中醫(yī)藥大學(xué);2012年

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本文編號：1582487