腔内激光消融术治疗下肢静脉性溃疡临床分析  

Clinical analysis on efficacy of endovenous laser ablation in treating venous ulcer of the lower extremities

作　　者：张光军[1] 杨治[1] 张海清[1] 姚凯[1] 单远洲[1] 张学利[1] 

机构地区：[1]上海交通大学附属第六人民医院南院普外科 上海市奉贤区中心医院普外科

出　　处：《临床外科杂志》2015年第5期354-356,共3页Journal of Clinical Surgery

摘　　要：目的：探讨腔内激光消融术（EVLA）治疗下肢静脉性溃疡（VULE）的疗效和安全性。方法32例（36条患肢，42处溃疡）VULE 患者，均行大隐静脉高位结扎＋EVLA 闭合曲张浅静脉及溃疡床周围穿通支静脉，术后穿循序弹力袜（20～30 mmHg）。结果手术时间30～90 min，平均50 min；术中出血量2～20 ml，平均10 ml；术后住院时间3～10 d，平均5 d。术后随访6～24个月，溃疡愈合率为90％（38／42），平均愈合时间为28 d（14～45 d），2年内累积溃疡复发率为7．9％（3／38）。患者生活质量较术前明显改善，无严重并发症。结论EVLA 能有效治疗 VULE，具有损伤小、并发症少、安全性高、溃疡复发率低等优点。Objective To evaluate the efficacy and the safety of endovenous laser ablation（EV-LA）in treating venous ulcer of the lower extremities（VULE）.Methods The clinical data of 32 patients （36 limbs,42 ulcers）with VULE during Jan.2010 to Dec.2012 were analyzed retrospectively.All patients were treated by high ligation combined with EVLA for superficial vein varicosity and perforator veins a-round the ulcer bed.Medical stocks（20 ~30 mmHg）were used routinely postoperatively.Results The mean operation time was 50 min（range,30 ~90 min）,the average blood loss was 10 ml（range,2 ~20 ml）,and the mean duration of postoperative hospitalization was 5 d（range,3-10 d）.During the follow-up time（range,6 -24 months）,the healing rate of ulcer was 90%（38 /42）,the mean healing time was 28 d （range,14 -45 d）,the accumulative rate of recurrent ulcer was 7.9%（3 /38）.Clinical symptoms and quality of life（QoL）improved significantly without major complications.Conclusion EVLA can treat VULE effectively.It has less invasiveness,fewer complications,higher safety and lower recurrent rate of ul-cer.

关 键 词：腔内激光消融术 静脉性溃疡 穿通支静脉 慢性静脉功能不全 

分 类 号：R654.4[医药卫生—外科学]