小切口大隐静脉次高位结扎联合腔内微波凝固加聚桂醇局部注射治疗下肢静脉曲张  

Small-incision High-ligation of Great Saphenous Vein Combined with Endovascular Microwave Coagulation Plus Local Injection of Lauromacrogol for Varicose Veins of Lower Limbs

作　　者：王建春[1] 陈坚[1] 刘绪舜[1] 

机构地区：[1]安徽医科大学解放军八一医院血管外科,南京210000

出　　处：《中国微创外科杂志》2015年第4期329-331,335,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨小切口大隐静脉次高位结扎联合腔内微波凝固加聚桂醇局部注射治疗下肢静脉曲张的可行性及疗效。方法 2012年10月~2013年10月我院血管外科60例70条患腿施行大隐静脉次高位结扎,大隐静脉主干插入微波腔内辐射器行腔内微波治疗,小腿局部侧支静脉血管迂曲处进行注射硬化剂治疗（观察组）;对照组（2011年8月~2012年9月）行传统大隐静脉高位结扎联合浅静脉剥脱术。比较2组患者手术时间、术中出血量、小切口数目、腹股沟处切口长度、术后并发症情况等。结果观察组手术时间（50.8±2.6）min,明显短于对照组（103.5±16.0）min（t=-25.183,P=0.000）;术中出血量（43.2±4.6）ml,明显少于对照组（107.5±35.2）ml（t=-14.030,P=0.000）;手术切口数（2.2±0.7）个,明显少于对照组（6.3±2.5）个（t=-12.233,P=0.000）;腹股沟处切口长度（2.3±0.3）cm,明显短于对照组（4.8±0.3）cm（t=-17.697,P=0.000）。术后并发症2组比较无显著性差异：局部皮肤麻木（观察组40例,对照组38例,χ2=0.147,P=0.702）,皮下淤血（观察组4例,对照组9例,χ2=2.157,P=0.142）。结论小切口大隐静脉次高位结扎联合腔内微波凝固加聚桂醇局部注射治疗大隐静脉曲张具有微创、美观、恢复快、疗效好、并发症少、操作简捷等优点。Objective To observe the feasibility and efficacy of small-incision high-ligation of great saphenous vein combined with endovascular microwave coagulation plus local injection of lauromacrogol for varicose veins of lower limbs.Methods From October 2012 to October 2013,there were 60 patients（70 legs） treated by high-ligation of the great saphenous vein,during which endovascular microwave coagulation was performed by using radiator and an additional injection of sclerotherapy at local tortuous vessels was carried out（observation group）.The control group（between August 2011 and September 2012） underwent the traditional saphenous vein ligation plus superficial vein stripping surgery.The operation time,blood loss during operation,number of incisions,length of groin incision,and postoperative complications were compared between the two groups.Results As compared with the control group,the observation group had singnificantly shorter operative time,fewer blood loss,fewer surgical incisions,and shorter groin incision,respectively [（50.8 ± 2.6） min vs.（103.5 ± 16.0） min,t =-25.183,P = 0.000;（43.2 ± 4.6） ml vs.（107.5 ±35.2） ml,t =-14.030,P = 0.000; 2.2 ± 0.7 vs.6.3 ± 2.5,t =-12.233,P = 0.000;（2.3 ± 0.3） cm vs.（4.8 ± 0.3） cm,t =-17.697,P = 0.000].There was no significant difference in complications rates between the two groups：local skin numbness occurred in 40 cases in the observation group and in 38 cases in the control group（χ2= 0.147,P = 0.702） and subcutaneous congestion was noted in 4 cases in the observation group and in 9 cases in the control group（χ2= 2.157,P = 0.142）.Conclusion Small-incision high-ligation of the great saphenous vein combined with endovascular microwave coagulation plus local injection of lauromacrogol for varicose veins of lower limbs has advantages of minimal invasion,good cosmetic outcomes,quick recovery,high efficacy,fewer complications,and easy performance.

关 键 词：大隐静脉曲张 微波凝固 聚桂醇 

分 类 号：R654.4[医药卫生—外科学]