DSA引导下使用聚桂醇泡沫硬化剂治疗下肢静脉曲张  

DSA-guided foam sclerotherapy of lauromacrogol in treatment of lower extremity varicose veins

作　　者：闫如虎[1,2] 吕维富 张万高[2] 陈大庆[2] 王前程[2] 徐允鹏[2] 吴媛媛[2] 

机构地区：[1]安徽医科大学附属省立医院介入放射科,安徽合肥230031 [2]安徽中医药大学第一附属医院介入中心

出　　处：《实用放射学杂志》2014年第10期1719-1722,1726,共5页Journal of Practical Radiology

摘　　要：目的：探讨DSA下使用聚桂醇泡沫硬化剂治疗下肢静脉曲张的临床效果。方法26例下肢静脉曲张患者（41条下肢）,其中1例并发下腔静脉回流障碍,3例并发髂静脉回流障碍,对于4例静脉回流障碍患者先行血管腔内成形术,1d 后采用聚桂醇泡沫硬化剂注射治疗,其余患者直接采用泡沫硬化剂注射治疗；在硬化剂注射方法中,24例采用直接穿刺曲张静脉注射治疗,2例患者采用逆行插管至患肢大隐静脉主干远端注射治疗。结果所有患肢均成功注射泡沫硬化剂于曲张血管内,平均注入5.88 mL 聚桂醇制成的泡沫硬化剂,术中及术后未出现严重并发症。随访1-12个月,硬化治疗的曲张静脉基本消失（92.3%,24/26）,少量曲张静脉残留（7.7%,2/26）,所有患者治疗后活动酸胀、沉重感消失,色素沉着消退,溃疡愈合。结论 DSA引导下使用聚桂醇泡沫硬化剂治疗各类下肢静脉曲张是一种微创、安全、有效的治疗方法。Objective To evaluate the clinical effect of DSA-guided foam sclerotherapy for lower extremity varicose veins.Methods A total of 41 legs in 26 patients with lower extremity varicose veins were treated with foam sclerosing agent of lauromacrogol un-der DSA guidance.4 cases with venous return disorder （3 in iliac vein and 1 in inferior vena cava）were treated with balloon dilatation first,and then lauromacrogol foam sclerotherapy after 24 hours.For injection method,2 patients were injected sclerosing agent through a catheter inserted in the trunk of great saphenous vein of sick limb with retrograde catheterization,and the others were in-j ected sclerosing agent directly in the varicose veins.Results The sclerotherapy was successfully accomplished in all affected limbs of 26 patients.The average dose of lauromacrogol for each patient was 5.88 mL.No serious complications occurred during and after operation.In 1 to 12-month follow-up,varicose veins disappeared in 24 patients （92.3%）,the soreness,fatigue and pigmentations disappeared in all patients,the ulcer healed in all limbs.Conclusion DSA-guided foam sclerotherapy is a micro-invasive,safe and ef-fective treatment for lower extremity varicose veins.

关 键 词：DSA 静脉曲张 泡沫硬化 聚桂醇 

分 类 号：R543.6[医药卫生—心血管疾病] R815[医药卫生—内科学]