目的：探讨在大隐静脉曲张手术中保留膝上主干的可行性。方法选取2013年8月至2014年10月于本院进行治疗的60例大隐静脉曲张患者，随机分为试验组和对照组，各30例。对试验组临床不同分期的大隐静脉曲张患者行保留膝上主干的剥脱术，对照组行传统大隐静脉高位结扎+剥脱术方式。随访观察两组试验对象的预后情况。结果试验组在疼痛评分、手术时间、出血量、住院时间、血肿例数等指标上显著优于对照组（t=3.268、4.325、5.670、5.931、c2=3.547，P<0.01），而深静脉血栓、静脉炎、复发率、血管内皮细胞生长因子（VEGF）、白细胞介素1（IL-1）水平两组对比差异无统计学意义。保留后的大隐静脉主干除腔内血流速度较术前减慢外（t=10.87，P<0.01），其管径、通畅度、隐股瓣膜功能、并发血栓等对比差异无统计学意义。结论相对于传统手术方式，保留大隐静脉膝上主干手术并未增加术后并发症发生率，由于其保留了大隐静脉主干，为大隐静脉曲张手术方式的多样性提供理论依据，为保留自身血管材料防治血管疾病，行血管库储备可行性提供了数据支持。%Objective To explore the feasibility of reserveing great saphenous varicose veins lap in varicosity operation. Methods Sixty cases with great saphenous vein varices from August 2013 to October 2014 were enrolled and evenly divided into two groups. Thirty cases of different clinical stages in trial group underwent surgical high stripping and ligation with preserving great saphenous varicose veins line. The control group were given routine traditional great saphenous vein high ligation + stripping. The two groups were followed-up for prognosis and data analysis. Results The trial group had statistically significant differences in pain score, operation time, blood loss, hospital stay, and indexes of hematoma than the control group (t=3.268, 4.325, 5.670, 5.931, c2=3.547, P<0.01), and deep vein thrombosis, phlebitis, recurrence rate, vascular endothelial growth factor (VEGF), interleukin-1 (IL-1) showed no significant differences. The trial group showed slower post-operative blood flow velocity (t=10.87, P<0.01), while its diameter, patency rate, valve function, and concurrent blood clots had no significant difference compared with preoperative ones. Conclusions Keeping great saphenous vein lap backbone shows no statistically significant differences in the incidence of postoperative complications. Because of retaining the great saphenous vein trunk, it provides the choice of diversity for the great saphenous varicose veins on preserving blood vessel bank.
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