下肢浅静脉曲张合并溃疡的腔内激光治疗(附89例报告)  

Endovenous Laser Treatment for Lower Limbs Varicose Veins Complicated with Ulcers: Report of 89 Cases

作　　者：孙春亮[1] 徐涛[1] 

机构地区：[1]解放军第401医院普外科,青岛266071

出　　处：《中国微创外科杂志》2013年第9期793-795,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腔内激光治疗大隐静脉曲张合并溃疡的疗效。方法2004年7月～2011年12月使用激光烧灼闭合溃疡周围和基底部异常静脉支，治疗大隐静脉曲张合并小腿溃疡89例94条肢体。结果手术时间35—130min，平均52min。溃疡全部愈合，溃疡愈合时间术后16—72d，平均29．3d。12例术后溃疡面积较术前一过性扩大，溃疡加深，分泌物增加，溃疡周围皮肤红肿、压痛，经静脉滴注抗生素、紫归长皮膏2号换药等处理，溃疡逐渐缩小直至愈合。9例术后溃疡部位出现较严重的疼痛，4～6周疼痛逐渐消失。75例随访2—6年，平均3．4年，未见溃疡复发。结论腔内激光治疗大隐静脉曲张合并溃疡具有效果确切，创伤小，恢复快等优点。Objective To explore the effect of endovenous laser treatment （EVLT） for varicose great saphenous veins complicated with ulcers. Methods A total of 89 cases （94 limbs ） of varicose great saphenous veins complicated with ulcers underwent EVLT from July 2004 to December 2011. The abnormal vein branches of the base of uclers and adjacent ulcers were burned and closed. Results The operation time was 35 - 130 min, with an average of 52 min. All the ulcers healed and the time of postoperative ulcer healing was 16 to 72 d, with an average of 29.3 d. Compared with preoperation, the ulcer area in 12 cases had a transient expansion, meanwhile, the ulcers deepened, secretions of ulcers increased, the skins around ulcers became red and swollen, and patients had tenderness. The ulcers gradually reduced and healed after intravenous antibiotic therapy and dressing change using Purple skin cream Ⅱ. The regions of ulcers in 9 cases presented serious pain after operation, which gradually disappeared in 4 - 6 weeks. Seventy five cases were followed up for 2 - 6 years,with an average of 3.4 years, and no recurrence was found. Conclusion EVLT for varicose great saphenous veins complicated with ulcers has the advantages of better effect, minimal incision, and quicker recovery.

关 键 词：腔内激光 大隐静脉曲张 溃疡 

分 类 号：R654.3[医药卫生—外科学]