透光旋切术与传统剥脱术治疗浅静脉曲张临床疗效对比分析  

Comparative analysis of clinical efficacy of transilluminated powered phlebectomy and traditional endarterectomy in treatment of varicose veins

作　　者：宋燕[1] 赵红丰 苗仁英 刘晋洋 方超[1] 付一群 

机构地区：[1]郑州大学第一附属医院血管外科,河南郑州450002

出　　处：《中国医药科学》2016年第13期211-214,共4页China Medicine And Pharmacy

摘　　要：目的对比分析传统静脉剥脱术与透光旋切术（TIPP）两种手术方式治疗浅静脉曲张的中长期有效性和安全性。方法 2013年6月-2014年6月患者行传统静脉剥脱术（对照组）,2014年6月-2015年7月行曲张静脉微创旋切术（实验组）,根据临床表现、病因学因素、病变的解剖定位和病理生理改变（CEAP）进行分级在C2-C4的患者进行大隐静脉高位结扎主干内翻剥脱后曲张静脉行静脉剥除术,分别随访患者术后2周和6月并发症情况。对比分析两种手术方式术后2周和6月并发症发生率。结果对照组术后2周并发症发生率如下：神经损伤6.8%,血肿4.6%,软组织感染1.5%,皮下出血12.9%,深静脉血栓形成2.2%,曲张静脉残留9.9%,实验组并发症发生率如下：神经损伤7.8%,血肿6.0%,软组织感染2.2%,皮下出血16.4%,深静脉血栓形成1.6%,曲张静脉残留3.8%,皮肤穿孔1.6%,术后6月对照组深静脉血栓0例,曲张静脉复发9.1%,实验组深静脉血栓0例,曲张静脉复发4.7%。结论相比传统曲张静脉剥脱术,透光旋切术能满足患者对美容的要求,术后恢复快,复发率较低,安全性和有效性得到验证,有很好的推广前景。Objective To comparatively analyze the medium and long term effectiveness and safety of traditional endarterectomy and transilluminated powered phlebectomy in treatment of varicose veins. Methods Patients cured during June 2013 to June 2014 were selected as control group and were treated with traditional endarterectomy, and patients cured during June 2014 to July 2015 were selected as experiment group and were treated with transilluminated powered phlebectomy. According to the clinical manifestations, etiological factors,anatomic location and pathological changes of the pathological changes（clinical-etiology-anatomic-pathophysiologic classification system,CEAP）,they were graded. Patients in grade C2-C4 were treated with high ligation of great saphenous vein trunk and stripping off, and followed by phlebectomy. They follow up for 2 weeks and 6 months respectively. The incidence of complications in 2 weeks and 6 months after operation were compared and analyzed. Results The complications of control group were as follows in two weeks： nerve injury 6.8%, haematoma 4.6%,cellulitis 1.5%,subcutaneous hemorrhage 12.9%, deep venous thrombosis 2.2%, varicose vein residual 9.9%. The complications of experiment group were as follows： nerve injury 7.8%, haematoma 6.0%, cellulitis 2.2%, subcutaneous hemorrhage 16.4%, and deep venous thrombosis 1.6%, varicose vein residual 3.8%. The complications of control group were as follows in six months： 0 case of deep venous thrombosis, 9.1% cases of varicose veins recrudescence. The complications of experiment group 0 cases of deep venous thrombosis, 4.7% cases of varicose veins recrudescence. Conclusion Compared with the traditional phlebectomy, TIPP meets the requirements of patients for cosmetic with fast postoperative recovery, low recurrence rate. Safety and effectiveness are verified. It has good prospects.

关 键 词：曲张静脉 传统手术 TIPP 疗效分析 

分 类 号：R654.4[医药卫生—外科学]