腔内激光闭合术联合刨吸术治疗大隐静脉曲张48例体会  

Endovenous Laser Therapy Combined with Planing Aspiration Operation for Great Saphenous Varicose(Experiences of 48 Cases)

作　　者：李乐[1] 李洪涛[1] 曹廷宝[1] 朱万坤[1] 韩晓鹏[1] 刘宏斌[1] LI Le LI Hong-tao CAO Ting-bao ZHU Wan-kun HAN Xiao-peng LIU Hong-bin(Department of General Surgery, Lanzhou General Hospital of Lanzhou Military Region, Lanzhou 730050, Gansu Province, Chin)

机构地区：[1]兰州军区兰州总医院普外科,甘肃兰州730050

出　　处：《中国普外基础与临床杂志》2016年第10期1236-1238,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的观察腔内激光闭合术联合刨吸术治疗大隐静脉曲张的疗效。方法笔者所在医院普外科2011年5月至2014年5月期间收治了大隐静脉曲张患者48例（60条患肢）,对大隐静脉主干采用腔内激光闭合术,小腿曲张静脉采用刨吸术治疗。结果 48例患者共60条患肢均手术治愈,单侧皮肤小切口1～3个,单侧手术时间18～43 min,平均22.6 min。术后患肢静脉曲张均消失,酸胀感消失,色素沉着减轻或消失;患肢疼痛轻微,均未用止痛药;患肢均有不同程度的皮下青紫,术后2周～1个月恢复,均无皮下血肿发生;皮肤灼伤2例,对症治疗后愈合;踝部肿胀5例,消肿治疗后6～13 d恢复;术后并发局部皮肤麻木6例,均在3～7个月内逐渐恢复。本组患者术后随访6～36个月,平均26.7个月,2例（2条患肢）失访,获访患者均无复发。结论腔内激光闭合术联合刨吸术治疗大隐静脉曲张安全有效,创伤小,疼痛轻,恢复快,无疤痕,手术时间短,住院时间短,值得临床推广。Objective To observe the efficiency of endovenous laser therapy combined with planning sucking operation in the treatment of great saphenous varicose veins. Methods Totally 48 patients （60 limbs） were treated from May 2011 to May 2014 in general surgery department of our hospital. The main trunk of great saphenous vein was ablated by endovenous laser treatment; and the varicose veins in calf were resected by planning sucking operation. Results All 48 patients （60 limbs） were cured without recurrent during 6-36 months followed-up. The operative time of each side was 18-43 min, the average operative time was 22.6 min; with 1-3 skin incisions. Hospital stay was 5-8 d, the average hospitalization time was 6.7 d. After operation, the varicose veins and the felling of swelling were disappeared, the pigmentation was reduced or disappeared. Local skin numbness showed in 6 cases and recovered in 3-7 months after operation. Felling of burns appeared in 2 cases, and was healed after treatment. Ankle swelling presented in 5 cases, and released in 6-13 d with related treatment. Different degree of subcutaneous bruising appeared without any hematoma, and recovered in 2-4 weeks. Two cases were lost during the followed-up. Conclusions Endovenous laser therapy combined with planning sucking operation is safe and effective in the treatment of great saphenous varicose. It is worthy of promotion with minimum damage, less pain, fast recovery, no scars, shorter operative time, and shorter hospital stay.

关 键 词：腔内激光闭合术 刨吸术 静脉曲张 微创 大隐静脉高位结扎术 静脉血栓 

分 类 号：R654.4[医药卫生—外科学]