腔内激光疗法联合透光旋切术与传统手术治疗大隐静脉曲张的临床对照研究  

Comparison of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity

作　　者：王钟林[1] 冯传波[1] 张海军[1] 邓建武[1] 王刚[1] 邵华[1] 苗永昌[1] 

机构地区：[1]江苏省连云港市第二人民医院血管外科,222023

出　　处：《中国综合临床》2016年第7期629-632,共4页Clinical Medicine of China

摘　　要：目的：比较腔内激光疗法（EVLT）联合透光旋切术（TIPP）与传统手术治疗大隐静脉曲张的临床效果。方法2014年1月至2015年1月共收治77例大隐静脉曲张患者，应用随机数字表法随机分为两组，37例接受腔内激光疗法联合透光旋切术，40例接受传统手术，比较两种手术方法的疗效。结果 EVLT＋ TIPP组手术平均时间为（66．1±14．7） min，平均出血量为（24．4±10．5） ml，手术切口数量为（5．7±1．7）个，平均住院时间为（5．6±1．4） d；传统手术组手术平均时间为（84．3±18．5） min，平均出血量为（59．0±15．6） ml，手术切口数量为（8．0±1．8）个，平均住院时间为（10．1±3．1） d，两组比较差异均有统计学意义（t值分别为－4．749、－11．460、－5．714，P均＜0．001）。两组患者均未出现严重并发症。 EVLT＋ TIPP组发生皮下硬结6例、皮下血肿5例、皮肤感觉异常7例；传统手术组发生皮下硬结2例、皮下血肿3例、皮肤感觉异常2例，两组比较差异均无统计学意义（ P均＞0．05）。两组患者随访12～24个月，平均（18±7）个月，EVLT＋ TIPP组复发1例，传统手术组复发2例，两组复发率比较差异无统计学意义（P＝1．000）。结论 EVLT＋TIPP治疗大隐静脉曲张效果确切，安全性好，与传统手术相比具有手术时间短、术中出血少、术后住院时间短、微创和美观的优点。Objective To compare the efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity. Methods From January 2014 to January 2015,77 patients diagnosed as great saphenous varicosity were enrolled. They were randomly divided into two groups, 37 patients received endovenous laser treatment combined with transilluminated powered phlebectomy and the other 40 patients underwent traditional surgical treatment. The related indicators were compared.Results The mean operation time,average bleeding volume,operative incisionquantity and average hospitalization time of EVLT＋ TIPP group were （66.1±14.7） min,（24.4±10.5） ml,5.7±1.7,（5.6±1.4） d respectively,of control group were （84.3±18.5） min,（59.0±15.6） ml,8.0±1.8,（10.1±3.1） d respectively,there were significant differences between the two groups（t =-4.749,-11.460,-5.714;P〈0.001） .There were no significant complications in the two groups.In the EVLT＋ TIPP group,6 patientsoccurred patsubcutaneous induration, 5 patients occurred subcutaneous hematoma and 7 patients had skinparesthesias.In the traditional operation group,2 cases occurred patsubcutaneous induration,3 cases occurredsubcutaneous hematoma and 2 cases had skin paresthesias.The EVLT＋ TIPP group was slightly higher than thetraditional operation group in the complications, but there were no significant differences between them （ P〉0.05）.During a mean follow-up time of （18±7） months（12 months to 24 months）,1 patient recurrence in theEVLT＋ TIPP group,2 cases recurrence in the traditional operation group.The recurrence rates of the two groupswere similar,the difference was not significant between them（P=1.000） .Conclusion Endovenous lasertreatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective andsafe.It also has the advanta and better cosmetic results.

关 键 词：静脉曲张 大隐静脉 激光 透光旋切术 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]