超声引导下泡沫硬化疗法联合主干高位透皮缝扎治疗原发性大隐静脉曲张的初步疗效  

Effect of ultrasound-guided foam sclerotherapy combined with percutaneous high ligation of great saphenous vein on primary great saphenous varicose

作　　者：冉寅呈 刘洪[1] 张矛[1] 李追[1] 曾秋[1] 赵渝[1] Ran Yincheng;Liu Hong;Zhang Mao;Li Zhui;Zeng Qiu;Zhao Yu(Department of Vascular Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院血管外科,400016

出　　处：《中华血管外科杂志》2018年第4期228-232,共5页Chinese Journal of Vascular Surgery

摘　　要：目的探讨超声引导下泡沫硬化疗法(FS)联合主干高位透皮缝扎(PHL)治疗原发性大隐静脉曲张的有效性和安全性。方法回顾性分析2017年6月至2017年10月重庆医科大学附属第一医院血管外科47例(50条患肢)在超声引导下经FS联合PHL治疗的原发性大隐静脉曲张患者的临床资料,记录患者手术时间、出血量及治疗费用;分别在患者术后1、3、6、12个月时随访,彩超检测大隐静脉闭合情况,计算主干闭合率,统计隐股交界处主干残端长度,记录患者静脉临床严重程度评分(VCSS)、生活质量调查表评分(CIVIQ),并观察并发症情况。结果手术时间(17.9±3.38)min,出血量(2.52±0.79)ml,治疗费用人民币(4488.00±511.76)元。术后1年大隐静脉主干一期闭合率84%(42/50),二期闭合率94%(47/50)。主干残端长度为(2.83±0.46)cm。术后1年VCSS评分及CIVIQ评分与术前比较,差异均有统计学意义[(3.06±1.23)分比(0.9±0.65)分,P<0.01);(83.13±7.49)分比(95.57±4.00)分,P<0.05];治疗有效率100%。随访期间,血栓性浅静脉炎21条,色素沉着35条,缝合点疼痛3例,肌间静脉血栓2例,无其他严重并发症发生。结论超声引导下FS联合PHL治疗原发性大隐静脉曲张微创,操作简单,费用低,安全有效,值得广泛推广。ObjectiveTo evaluate the treatment effect of ultrasound-guided foam sclerotherapy (UGFS) combined with percutaneous high ligation (PHL) of great saphenous vein on primary great saphenous varicose (GSV).MethodsThe clinical data of 47 cases (50 limbs) with primary varicose veins due to GSV incompetence who were treated by UGFS combined with PHL from June 2017 to October 2017 were retrospectively reviewed. Duration of operation, blood loss and cost were collected in this study. During one year's follow-up, the closure rate of GSV, the length of saphenous stumps, VCSS, CIVIQ and complications were recorded.ResultsThe duration of operation was (17.9±3.38) minutes, the amount of bleeding was (2.52±0.79)ml, and the cost was ￥(4488.00±511.76) yuan. The primary GSV closure rate was 84% (42/50) , and the second GSV closure rate was 94% (47/50) one year post-operative. The length of saphenous stumps was 2.83±0.46cm. VCSS declined from 3.06±1.23 to 0.9±0.65 (P<0.01) and CIVIQ improved from 83.13±7.49 to 95.57±4.00 (P<0.05), which showed 100% effective rate. There were 21 limbs of thrombophlebitis, 35 limbs of hyperpigmentation, 3 limbs of saphenous junction pain, 2 limbs of intermyovenous thrombosis, and no other severe complication.ConclusionsApplying PHL to UGFS of the saphenous stem enhanced the short-term occlusion rate. The procedure is simple, minimally invasive, inexpensive, effective, safe, and worthy of clinical promotion.

关 键 词：泡沫硬化疗法 高位透皮缝扎 原发性大隐静脉曲张 

分 类 号：R65[医药卫生—外科学]