微创手术治疗中下肢静脉曲张管壁的形态学改变

E.G. Cherkasheninov
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引用次数: 0

摘要

探讨静脉内激光联合射频消融治疗静脉曲张患者的静脉壁情况。静脉曲张切除的静脉碎片作为病理形态学研究的材料。根据Mallory的说法,使用了以下组织学染色方法:苏木精和伊红,van Gieson 's微红精在弹力上进行额外染色。研究表明,下肢静脉曲张,静脉壁发生明显的不可逆形态变化,表现为内皮细胞损伤,静脉壁各层肥大,结缔组织发育,内皮细胞基底膜、肌肉层和弹性层的胶原结构受损。在所有研究组中都可以追踪到静脉壁胶原结构的变化,这似乎是可能的,因为采用微创方法的治疗是在已经改变的静脉干的背景下进行的。同时,静脉内激光凝固静脉时,静脉壁损伤最为明显,术后常伴有疼痛。后者通过静脉壁完全坏死的形态改变得到证实,坏死和内皮完全脱屑进入血管腔。下肢静脉壁的损伤,由于静脉曲张的慢性血流过程而改变,包括其内皮和所有层,当使用射频消融术时可以最小化。因此,射频消融作用区周围织物的愈合将在更短的空间内完成,对患者有一个有利的结局,这可以通过术后静脉运动的感觉异常和疾病的减少来证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Morphological changes in the walls of varicose veins of the lower extremities during minimally invasive surgical treatment
The vein wall was investigated in the treatment of patients with varicose veins by endovenous laser and radiofrequency ablation. Fragments of removed veins with varicose veins served as material for pathomorphological research. The following histological staining methods were used: hematoxylin and eosin, van Gieson’s picrofuchsin with additional staining on elastica, according to Mallory. It has been shown, that with varicose veins of the lower extremities, pronounced irreversible morphological changes develop in the vein wall in the form of damage to endothelial cells, hypertrophy of all layers of the vein wall, total development of connective tissue in it with impaired collagen structure both in the basement membrane of endothelial cells and in muscle and elastic layers. Changes in the structure of collagen in the vein wall can be traced in all studied groups, which seems possible, since the treatment with minimally invasive methods is carried out against the background of already altered venous trunks. At the same time, injuries in the vein wall are most pronounced when using endovenous laser coagulation of veins and are accompanied by frequent pain in the postoperative period. The latter is confirmed by morphological changes in the form of total necrosis of the vein wall with necrosis and complete desquamation of the endothelium into the lumen of the vessel. Damage to the wall of the vein of the lower extremities, altered by a chronic current process with varicose veins, including its endothelium and all layers, is minimized when using radiofrequency ablation. Accordingly, cicatrization of surrounding fabrics in the zone of action of radiofrequency ablation will pass in more short spaces and with a favourable end for a patient, that it is confirmed by the less number of paresthesias and sickliness on motion a vein in a postoperative period.
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