导管引导下泡沫硬化剂疗法治疗大隐静脉曲张  

Catheter-directed foam sclerotherapy of incompetent saphcnous reflux： early results

作　　者：刘小平[1] 郭伟[1] 贾鑫[1] 杜昕[1] 熊江[1] 尹太[1] 张宏鹏[1] 刘蒙[1] 

机构地区：[1]解放军总医院血管外科,北京100853

出　　处：《中华外科杂志》2009年第24期1873-1875,共3页Chinese Journal of Surgery

摘　　要：目的探讨导管引导下的泡沫硬化剂疗法治疗下肢静脉曲张的临床效果。方法选择2008年4月至8月间有微创治疗意愿的30例（条）中重度下肢静脉曲张患者。其中男性11例，女性19例；年龄34～85岁，平均年龄52岁。病史2～30年，平均20年。对其进行导管引导下患肢大隐静脉主干内注射1％聚桂醇泡沫硬化剂，观察大隐静脉主干的闭合情况。结果30条患肢均在导管引导下成功注射硬化剂，平均每条患肢应用6．2ml泡沫硬化剂，27条（90％）大隐静脉主干治疗后即刻可见反流消失。术后早期大隐静脉走行轻微浅静脉炎5例（条），2周内自行缓解，无严重的并发症发生。平均随访3个月，27例患者下肢活动后酸胀、乏力感消失，下肢明显的曲张畸形静脉消失；27条患肢（90％）于治疗后2周、3个月后复诊血管超声时大隐静脉主干闭塞。4例（条）患者（15％）仅有小腿局限的轻度曲张。结论导管引导的泡沫硬化剂疗法治疗下肢静脉曲张的大隐静脉主干闭合率较高，是微创治疗下肢静脉曲张有效的新方法。Objective To describe observation of availability of catheter-directed foam sclerotherapy for the great saphenous vein varicosis. Methods A selective series of 30 patients of vein varicosis were treated with foam sclerotherapy using a standard technique for foam delivery from April 2008 to August 2008. Patients were treated with 1% polidocanol foam through a catheter, which was inserted pereutaneously over a guidewire in the great saphenous vein （GSV）. All successfully treated patients were examined by colour duplex two weeks after the procedure. Results Thirty patients with an insufficiency reflux of the GSV were treated with the catheter-directed foam sclerotherapy. Primary technical success was achieved in all the patients. The concentrations （ 1.0% ） and doses （ 6 to 8 ml ） of polidocanol was mainly we used. Five patients experienced transient scotomas and developed segmental phlebitis of a collateral vein. The intervention was well tolerated in all patients without the occurrence of serious side effects. In 27 of the 30 treated patients （90%） , a closure of the GSV was found at control visits 2 weeks, 3 months after treatment. Conclusion The use of an endovaseular catheter inserted percutaneously over a guidewire is feasible in most patients and has resulted in high primary occlusion rates.

关 键 词：静脉曲张 硬化疗法 导管插入术 外周 

分 类 号：R686[医药卫生—骨科学]