The Clinical Research In The Treatment Of Primary Deep Venous Valve Insufficiency Of Lower Extremity With Two Different Surgical Methods

Background and objectiveAs one of the most common diseases of the lower limb venous systerm,Primary Deep Venous Insufficiency of the lower limb seriously affects the patient's quality of life and routine works.Some researchers believe that the simple high ligation and ablation of the great saphenous vein is an effective treatment,but some researchers think that the treatment of deep veins and superficial veins of the lower limb can improve the symptoms of patients more effectively.As one of the treatment of deep veins,the valve in situ wrapping of the superficial femoral vein,can reduce venous blood reflux in the lower limb effectively.The study aimed to compare the simple high ligation and ablation of the great saphenous vein and combined with the valve in situ wrapping of the superficial femoral vein in the treatment of primary deep venous valve insufficiency.Materials and methodsThis study is a retrospective analysis.We collected the related clinical data of 235 patients(272 lower limbs)with primary deep venous insufficiency.As the observation group,there are 157 patients(181 lower limbs)who were treated with the simple high ligation and ablation of the great saphenous vein combined with the valve in situ wrapping of the superficial femoral vein,that from The Second Clinical College of Zhengzhou University during 2014.03 to 2016.03.AS the control group,there are 78 patients(91 lower limbs)who were treated with the simple high ligation and ablation of the great saphenous vein,that during 1999.03 to 2000.09.Measured the average blood velocity of the femoral veins where is above the great saphenous veins' entry point about 1 cm,and the reflux time of the first valve of the superficial femoral vein under the Valsalva test by Color Doppler ultrasonography of all patients before,two weeks after the operation and at 24 months after surgery,then compared the changes.In addition,evaluated the clinical efficacy of 24 months after surgery by CEAP clinical classification and scoring.ResultsThe data displayed the two groups were comparable in age,gender,and preoperative clinical grade.And there were no significant differences in postoperative complications such as incision infection,lymphatic leakage,and deep vein thrombosis of the lower limb.Those differences between the two groups were significant in the average blood velocity of the femoral veins and the reflux time the first valve that we measured at two weeks after surgery and 24 months after surgery by Color Doppler Ultrasound.And those differences of the measurement index in the observation group were more significant than the control group.The clinical scores at 24 months after surgery were significantly different from those before surgery,and those differences in the observation group were significantly better than the control group(P<0.05).ConclusionThe simple high ligation and ablation of the great saphenous vein combined with the valve in situ wrapping of the superficial femoral vein has more obvious advantages than the simple high ligation and ablation of the great saphenous vein for the treatment of primary deep venous valve insufficiency,and easier to promotion,so the combined surgery is the ideal method.