内镜下大隐静脉切除术与大隐静脉剥脱术治疗下肢静脉曲张近期疗效比较  

A comparison between endoscopic resection and conventional stripping for lower extremity varieosis

作　　者：钱松屹[1] 刘鹏[1] 甄雅楠[1] 叶志东[1] 王非[1] 林凡[1] 杨煜光[1] 刘江涛[1] 樊雪强[1] 王风林[1] 

机构地区：[1]中日友好医院心脏血管外科,北京100029

出　　处：《中华普通外科杂志》2015年第4期264-267,共4页Chinese Journal of General Surgery

摘　　要：目的比较内窥镜下大隐静脉切除术及大隐静脉剥脱术联合透光旋切术治疗下肢静脉曲张的近期疗效。方法回顾性分析2012年1月至2013年6月收治的有明确大隐静脉反流的下肢静脉曲张的66例患者（77条肢体）的临床资料，其中32例（36条肢体）采用内窥镜（endoscoptic vein harvesting，EVH）治疗；34例（41条肢体）采用内翻剥脱术。2组均联合透光旋切术（transilluminated poweredp hlebeetomy，TIPP）治疗。比较2种方法手术时间、手术切口、术中出血量、术后住院时间、术后并发症及术后1年时的复发率。结果手术时间EVH组较内翻剥脱组为长。术后住院时间EVH组（2．2±0．4）d与内翻剥脱组（3．4±0．6）d相比较短，二者差异有统计学意义（P〈0．01）。EVH组较内翻剥脱术组手术切口少（P〈0．01）；术后1年两组复发率相当（P〉0．05），隐神经损伤发生率，内翻剥脱组与EVH组差异无统计学意义（P〉0．05）。结论EVH治疗下肢静脉曲张创伤小，并发症少，近期效果良好。Objective To compare the clinical results of endoscopic greater saphenous vein venectomy combined with transilluminated powered phlebectomy （TIPP） and conventional stripping combined with TIPP for lower extremity varicosis. Methods We retrospectively analyzed data of 66 patients （77 limbs） with primary vein varicosis of the lower extremity who underwent EVH with TIPP （32 cases ,36 limbs）or conventional stripping with TIPP （34 cases ,41 limbs） in our department from Jan 2012 to Jun 2013. Operation time, number of the incision made, postoperative hospital stay, complications, and one-year recurrence rate were compared with each other. Results Operation time in EVH group was longer than in stripping group. Postoperative hospital stay was shorter in EVH and TIPP group （2. 2 ＋ 0. 4） d than that in stripping and TIPP group （3.4 ＋0. 6） d （P 〈0. 001 ）. Patients in stripping group also suffered from more incisions when compared with EVH group （ P 〈 0. 001 ）. There were no significant diffrences in one-year recurrece rate and incidental nervus saphanus iniury in the two groups （P 〉 0. 05）. Conclusions EVH is less invasive, with smaller incison than conventional stripping for the treatment of lower extremity varicose vein and favorable short term prognosis.

关 键 词：静脉曲张 血管外科手术 

分 类 号：R654.3[医药卫生—外科学]