| Background and Objective: Chronic venous insufficiency (CVI) in lower limbs is one of common and frequently-occurring diseases in surgery, generally accompany with dilation or impaired function in communicating vein, which closely related to clinical manifestation of the patients. Color Doppler ultrasound is one of the most accurate and convenient methods to exam the communicating vein in lower limbs. This study measured the communicating vein in lower limbs venous insufficiency patients and healthy people, analyzed the correlation between levels of clinical manifestation, observed the effect after the communicating vein ligature treatment and evaluated its application value in the treatment.Methods: 98 cases of lower limbs venous insufficiency patients (65 of male, 33 of female) aged 26-76(mean age 55) are selected from Sep,2007 to Oct, 2009. 100 healthy people (68 of male, 32 of female) are in age of 33-72(mean age 51). SonoSite 180PLUS Color Doppler ultrasound was used to measure the number, internal diameter, and blood speed of communicating vein in lower limbs in both disease and healthy group. The affected limbs were CEAP classification diagnosed and the number, internal diameter, blood speed and backflow time of insufficiency communicating vein were checked according to clinical level of C0~6 and correlations were analyzed. The localization of communicating vein was made by Color Doppler ultrasound before operation, Subfascial endoscopic perforator surgery (SEPS) was held on the insufficiency communicating vein, and the treatment effects were observed and followed up.Results:1. Healthy group: 35 communicating vein were tested and detection rate was 21%. The mean value of number, internal diameter and blood speed of communicating vein were 2, 1.9mm and 1.5cm/s; Those of Dodd were 3, 1.0mm and 1.2cm/s; Those of Boyd were5, 1.5mm and 1.8cm/s; Those of Cockettâ…¢were7, 1.3mmand 1.5cm/s; Those of Cockettâ…¡were 7, 1.2mm and 1.2cm/s, those of Cockettâ…¡were 11, 1.2mm and 1.1cm/s. There were no significant differences among them(P>0.05).2. Affected group: 100 communicating vein were tested and detection rate was 100% in CVI patients. The mean value of number, internal diameter, blood speed and backflow time of communicating vein were 9, 5.2mm, 3.0cm/s and 5.0s; Those of Dodd were 15, 4.0mm, 2.8cm/s and 3.5s; Those of Boyd were 27, 3.5mm, 2.6cm/s and 3.2s; Those of Cockettâ…¢w ere 36, 2.8 mm, 2.5cm/s and 2.5s; Those of Cockettâ…¡were 52, 2.2mm, 2.2cm/s and3.0s, those of Cockettâ…¡w ere 66, 2.5mm, 2.5cm/s and 2.2s.3. The mean value of number, internal diameter, blood speed and backflow time of communicating vein in patients group were all larger than those of healthy group. There were significant differences among them(P<0.01).4. Positive correlation could be established between the clinical manifestation level and the mean value of number, internal diameter, blood speed and backflow time of communicating vein tested by Color Doppler ultrasound, the correlation coefficients were 0.45, 0.56, 0.52 and 0.51.5. Adopting Subfascial endoscopic perforator surgery (SEPS) operation, the cicatrisation time of ulcer limb of 16 cases of C5 was within 1 month, that of 7 cases of C6 within 2.5 months. Follow up 1-3years, no recurrence of ulcer limbs was found.Conclusion:1. This study measure the mean value of number, internal diameter, blood speed and backflow time of communicating vein in detail and provide reference data for clinic.2. Color Doppler ultrasound may detect the value of number, internal diameter and blood speed of communicating vein in lower limb, especially benefit for the detection of number, internal diameter blood speed and backflow time of communicating vein in CVI patients.3. Positive correlation can be established between the clinical manifestation level and the number, internal diameter, blood speed and backflow time of communicating vein in CVI patients tested by color Doppler ultrasound.4. Color Doppler ultrasound guiding SEPS operation in communicating vein of CVI patients makes content treatment effectiveness and its utilization value is high. |
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