大隐静脉属支结扎与否对微波腔内闭合术疗效的影响  

Does ligation or nonligation of great saphenous vein tributaries influence the efficacy of endovenous microwave ablation?

作　　者：粟文娟[1] 王小平[1] 常征[1] 张宇[1] 蔡惠群[1] 王群[1] 王珊珊[1] 王徐红[1] 

机构地区：[1]上海中医药大学附属市中医医院功能科,上海200071

出　　处：《中国普通外科杂志》2013年第6期710-715,共6页China Journal of General Surgery

基　　金：第三批上海市中医临床优势专科(专病)建设资助项目(ZYSNXD-YL-YSZK010);上海市中西医结合重点病种建设资助项目(zxbz2012-09)

摘　　要：目的:观察大隐静脉5大属支结扎与否对微波腔内闭合术治疗大隐静脉曲张疾病效果的影响。方法:对600例大隐静脉曲张疾病患者行微波腔内闭合术,其中,400例(635条患肢)采取大隐静脉高位结扎加主干微波腔内闭合术,经皮穿刺微波闭合下肢浅表曲张静脉与病变交通静脉(观察组);200例(313条患肢)除以上处理外,结扎大隐静脉5个属支(对照组)。结果:两组患者术后均获满意疗效。两组间浅静脉曲张、患肢肿胀、色素沉着、溃疡的改善情况及术后并发症发生率、5年复发率等均无明显差异(均P>0.05)。超声影像学显示,观察组术后股总静脉流速较术前明显减慢,内径明显减小(均P<0.05);而对照组术后股总静脉流速较术前明显减慢(P<0.05),但内径减小未达统计学意义(P>0.05)。结论:大隐静脉5大属支结扎与否不影响微波腔内闭合术治疗大隐静脉曲张疾病的效果。Objective： To observe the influences of ligation or non-ligation of the five main tributaries of the great saphenous vein （GSV） on the efficacy ofendovenous microwave ablation for GSV varicose veins. Methods： Endovenous microwave ablation was performed in 600 patients with GSV varicose veins. Of the patients, 400 cases （635 limbs） underwent GSV high ligation plus endovenous microwave ablation of the main GSV trunk, and percutaneous microwave ablation of the superficial varicose veins and pathological perforating veins of the legs （observational group）, while another 200 cases （313 limbs） were subjected to ligation of the five main GSV tributaries in addition to the above mentioned procedures （control group）. Results： Satisfactory clinical efficacy was obtained in both groups of patients after operation. No significant differences were noted between the two groups in the improvement of the superficial varicose veins, leg swelling, pigmentation and ulcers, as well as the incidence of postoperative complications and 5-year recurrence rate （all P〉0.05）. Ultrasound imaging showed that the flow velocity and inner diameter of the common femoral vein in observational group were significantly reduced after operation versus those before operation （both P〈0.05）; while in control group, the flow velocity of the common femoral vein was significantly decreased （P〈0.05）, but the decreased level of the inner diameter did not reach a statistical significance compared with that before operation （P〉0.05）. Conclusion： Whether the five main GSV tributaries are ligated or not does not substantially influence the outcomes of endovenous microwave ablation in treatment of GSV varicose veins.

关 键 词：静脉曲张 外科学 隐静脉 微波腔内闭合术 

分 类 号：R654.4[医药卫生—外科学]