超声引导泡沫硬化剂注射与传统手术治疗大隐静脉曲张疗效及安全性Meta分析  

Clinical efficacy and safety of ultrasound-guided foam sclerotherapy versus conventional surgery in treating varicosis of great saphenous vein:a meta-analysis

作　　者：陈智勇[1] 司小毛[1] 仇鹏[1] 余康敏[1] 朱化刚[1] 

机构地区：[1]安徽医科大学第一附属医院血管外科,合肥230032

出　　处：《中国血管外科杂志（电子版）》2014年第1期26-30,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：安徽省自然科学基金(07021005)

摘　　要：目的比较并评价超声引导硬化剂注射(UGFS)和传统大隐静脉高位结扎+抽剥术(CS)治疗大隐静脉(GSV)曲张的疗效及安全性。方法检索2003年12月至2013年12月发表的有关比较UGFS和CS治疗GSV曲张疗效的文献,并用Meta分析评价二种手术方法的手术失败率、隐神经损伤率、术后血栓性浅静脉炎发生率等指标。结果共纳入9篇文献,均为前瞻性随机对照研究,包括1 478例患者共1 608条肢体,其中UGFS组1002条,CS组606条。UGFS组的手术失败率明显高于CS组,差异有统计学意义(OR=2.18,95%CI 1.60~2.98,P【0.001)。两组术后血管再通率比较差异无统计学意义(P】0.05);UGFS组隐神经损伤率明显低于CS组(OR=0.17,95%CI0.07~0.42,P【0.001),术后血栓性浅静脉炎发生率高于CS组(OR=4.02,95%CI 2.08~7.77,P【0.001),差异均有统计学意义。UGFS组术后切口感染、皮下血肿发生率低,差异无统计学意义(P】0.05)。结论 UGFS治疗GSV曲张安全可行,其手术成功率有待提高,但与传统手术比较,发生隐神经损伤、切口感染、皮下血肿等并发症机会减少。Objective To compare the clinical efficacy and safety of ultrasound-guided foam sclerotherapy(UGFS)versus conventional surgery(CS)in treating varicosis of great saphenous vein using Meta-analysis method. Methods Randomized controlled trial (RCT)comparing UGFS and CS clinical effects of nine papers which were published from December 2003 to December 2013 were recruited. Meta-analysis was conducted to estimate the primary operation failure rate,saphenous nerve injury rate,postoperative superficial thrombophlebitis rate. Results Nine RCTs were searched in this analysis. There were 1 478 patients (1 608 limbs),including 1 002 limbs in UGFS group than that in and 606 limbs in CS group. The primary operation failure rate was higher in the UGFS group and the difference was statistically significant(OR=2.18,95%CI 1.60~2.98,P<0.001).There were no statistically significant differences in postoperative recanalisation rates between two groups (P>0.05). Saphenous nerve injury rates in UGFS group were lower than those in CS group (OR=0.17,95%CI 0.07~0.42,P< 0.001), but postoperative superficial thrombophlebitis incidences were higher than that in CS group(OR=4.02,95%CI 2.08~7.77,P<0.001). The wound infection rate and haematoma rate were lower in UGFS group, but those differences were not significant(P>0.05). Conclusion UGFS is safe and feasible in treating varicosis of great saphenous vein,but the surgery success rate has to be improved. Saphenous nerve injury, wound infection and subcutaneous hematoma opportunities occurred afrer UGFS less than those afrer CS.

关 键 词：大隐静脉曲张 泡沫硬化剂 传统手术 META分析 

分 类 号：R654.4[医药卫生—外科学]