腔内激光闭合大隐和曲张浅静脉治疗下肢慢性静脉疾病  

Endovenous Laser Treatment of Chronic Venous Diseases by Ablating Varicose Great Saphenous Vein and Tributary Varices

作　　者：陈克辉[1] 吴茂松[1] 汤永胜[1] 杨春建[1] 刘咸罗[1] 陆信武[2] 

机构地区：[1]安徽省合肥市第二人民医院血管外科,230011 [2]上海交通大学医学院附属第九人民医院血管外科,200011

出　　处：《中华全科医学》2012年第1期38-39,共2页Chinese Journal of General Practice

摘　　要：目的评价腔内激光闭合大隐和曲张浅静脉治疗下肢慢性静脉疾病(CVD)的有效性。方法回顾分析2005年4月-2009年12月应用腔内激光闭合大隐和曲张浅静脉治疗的CVD患者的临床资料,纪录患者术前和术后的症状和体征,评价大隐静脉高位结扎和腔内激光治疗后大隐和曲张浅静脉的闭合情况,症状和体征的变化及与手术相关的并发症。结果共应用腔内激光闭合大隐和曲张浅静脉治疗CVD 356条患肢;术后平均随访时间28个月,能使97.2%的患肢大隐和曲张浅静脉达到完全闭合,再治疗率为2.8%。术后主要并发症有淤斑、硬结、疼痛、麻木和灼伤等,但这些并发症均为自限性,无其他严重并发症发生。结论腔内激光闭合大隐和曲张浅静脉能显著缓解下肢慢性静脉疾病症状和体征,并能取得良好的美容效果,启动激光前去血和术后压迫能提高其治疗效果。Objective To evaluate the effect of endovenous ablation with laser on chronic venous disease（CVD） by ablating the great saphenous vein and tributary varices.Methods The clinical data of CVD patients with endovenous laser ablation by ablating the great saphenous vein and tributary varices from April 2005 to December 2009 were evaluated.A questionnaire was used to assess preoperative and postoperative symptoms.Effectiveness was assessed by the obliteration of the vein,disappearance of varicosities,and so on.The primary outcomes for assessing safety were mortality and morbidity,including laser-related adverse events.Results A consecutive series of 312 patients were treated by EVLA for GSV reflux and tributary varices.Treatment with EVLA plus ligation of the GSV resulted in occlusion in 346 of 356（97.2%） at mean 28 months follow-up;the rate of retreatment was low（2.8%）.The main postoperative complications were ecchymosis,induration,pain,anaesthesia and burn,and all of them were self-limiting.Conclusion The endovenous laser ablation can reduce and relieve the symptoms associated with varicose veins and achieve cosmetic goals.Vein emptying before exposure to laser energy and postoperative compression treatment may improve the outcomes.

关 键 词：腔内静脉闭合 大隐静脉 曲张浅静脉 慢性静脉疾病 

分 类 号：R654.4[医药卫生—外科学]