曲张大隐静脉激光成形术术式改良与其疗效的临床研究  

Time-reserved Effect of Improved Endovenous Laser Ablation in the Treatment of Great Saphenous Vein Varicosities： A Historical Control Clinical Trial

作　　者：梁彦[1] 杨倩[1] 颜建章[1] 赵宇飞[1] 高登鹏[1] 

机构地区：[1]廊坊市人民医院,河北廊坊065000

出　　处：《中国血液流变学杂志》2012年第1期88-90,158,共4页Chinese Journal of Hemorheology

基　　金：廊坊市科学技术研究与发展计划自筹经费项目（2011013011）

摘　　要：目的 探讨腔内激光治疗术改进术式在治疗大隐静脉曲张患者中缩短手术时间的作用,及其对手术效果的短期影响.方法 选择2009年8月～2011年6月收治的大隐静脉曲张患者,经术前查体及多普勒超声检查排除严重深静脉反流等情况54例患者作为实验对象,应用改良激光治疗术式操作;采用历史对照的研究方法,调取2008年5月～2009年8月应用传统激光治疗术式操作的50例患者,作为对照;观察两组手术时间、术中操作是否顺利、术中是否需行静脉远端切开,及术后第3、7天,和第1、6个月患者术后疼痛、术后副损伤、复发等情况.结果 患者术后皮下出血、条索样硬结、疼痛、皮肤浮肿、烧灼、坏死、肺栓塞、深静脉血栓等发生率和患者恢复日常活动所需的时间未见有统计学差异,而改良激光手术组手术时间明显缩短（P〈0.05）、术中顺利穿刺置光纤成功率增加（P〈0.01）、术中行大隐静脉远端切开率明显减少（P〈0.05）.结论 曲张大隐静脉改良腔内激光治疗术能够缩短手术时间,降低大隐静脉远端切开的风险,增加术中顺利置光纤的成功率.Objective To study the time-reserved effect and early postoperative morbidity of improved endovenous laser ablation（IEVLA） in the treatment of great saphenous vein（GSV） varicosities.Methods All of the venous vaxicoses cases,who had been admitted in our department from Aug 2009 to Jun 2011,were persuaded to join the study.When ultrasonograph exclude the existence of deep vein disease,a total of 54 cases（73 limbs）,as a experimental group,were obtained to enter the study, and then received the operation of IEVLA.And using historical control studying manner, we selected 50 patients（64 limbs） as the control group,who had been treated by traditional endovenous laser ablation（TEVLA） during May 2008 to Aug 2009.And then local pain,ecchymos- is,induration,paraesthesia in treated regions,easy or not of the operation,section or not in the lower of GSV, time of procedure duration and early postoperative morbidity were recorded.Follow-up visits were planned on the 3~ postoperative day,7~ day,1S＇ and 6th months.Result There was no significant difference on local pain,ecchymosis, induration,paraesthesia in treated regions,skin necrosis,skin burn,deep vein thrombosis,pulmonary embolus,retum to daily activity,6th month closure rate.Whereas in group IEVLA the time of procedure duration was shorter, the success ratio of playing fiber higher, section ratio in the lower of GSV less.Conclusion Treatment of the GSV by improved endovenous laser ablation resulted in less section ratio in the lower of GSV（P 〈 0.05）,higher success ratio of playing fiber（P 〈 0.01）,and shorter procedure duration time（P 〈 0.05）.

关 键 词：大隐静脉 静脉曲张 腔内激光治疗术 

分 类 号：R543.6[医药卫生—心血管疾病]