Laparoscopic Deep Subfascial Ligation Of Communicating Veins For Treatment Of Deep Venous Valve Function Of Lower Extremities Incomplete Clinical Research

Objective:To explore the clinical therapeutic effect of endoscopic deep subfascial communication vein ligation in patients with lower limb deep venous valve insufficiency,and to provide methods and ideas for clinical treatment.Methods:A retrospective analysis of 72 patients who came to our hospital from September 2015 to September 2017 for the treatment of deep vein valve insufficiency in the lower extremities was taken as the research object.All patients meet the diagnostic criteria for lower extremity deep venous valvular dysfunction developed by the European Vein Forum for lower extremity venous diseases,and complete antegrade angiography of lower extremity veins and frog test(assessment of blood flow)before surgery,depending on the way Divided into a control group and an observation group,the control group was treated with high saphenous vein ligation + intracavity laser closure,and the observation group was treated with high saphenous vein ligation + intracavity laser closure + endoscopic deep subfascial traffic vein ligation,Evaluate the clinical efficacy after 1 week of treatment,and follow up for 36 months.CEAP method was used to evaluate the clinical symptoms and signs of the two groups before operation and 1 week after operation;record the operation parameters of the two groups,including: operation,hospital stay,intraoperative blood loss,and number of incisions;record the two groups before operation and after operation 2 Peripheral vein diameter,average blood flow velocity,duration of reflux;record the CEAP grading before and after 36 months of operation in both groups;The incidence of recurrence,ulceration,infection of incision,pain in the affected limb,lymphatic leakage and deep vein thrombosis during postoperative follow-up was recorded and counted,and the clinical treatment effects of the two groups were compared.Results:(1)The clinical symptoms and signs scores of the two groups after 1 week of treatmentwere lower than before treatment(P <0.05);the superficial varicose veins,venous edema,pigmentation,lipid sclerosis,pain of the observation group 1 week after treatment,Ulcer time,ulcer size scores are lower than the control group(P <0.05);(2)The operation time of the observation group was longer than that of the control group(P <0.05);the hospitalization time,intraoperative blood loss,and the number of incisions in the observation group were shorter(less)than those in the control group(P<0.05);(3)The venous diameter and duration of reflux in the observation group 1 week after surgery were both lower(shorter)than the control group(P <0.05);the average blood flow velocity in the observation group 1 week after surgery was greater than that in the control group(P <0.05));(4)The hemodynamic levels of the two groups after 1 week of treatment were lower than before treatment(P <0.05);the observation group had fibrinogen,hematocrit,whole blood high shear viscosity,plasma viscosity and 4 weeks after treatment The whole blood low-cut viscosity level was lower than that of the control group(P <0.05);(5)There was no statistically significant difference in the number of C0 and C1 cases between the observation group and the control group 1 week after surgery(P> 0.05);the number of CEAP graded C3 cases 1 week after the observation group was more than the control group(P <0.05);The number of CEAP,C5,C6 cases in the observation group 1week after surgery was less than that in the control group(P <0.05);(6)Both groups were followed up for 36 months after the operation.The incidence of recurrence,ulceration,incision infection,pain in the affected limb,lymphatic leakage and deep vein thrombosis in the observation group were lower than those in the control group(P<0.05).Conclusion:High saphenous vein ligation + intraluminal laser closure + endoscopic deep sub-fascial venous ligation combined treatment of patients with deep venous valve insufficiency in lower extremities can significantly improve the clinical symptoms and signs of patients.Improving the patient's hemodynamic level,the postoperative complications and recurrence rate are low,and it is worth popularizing and applying.