聚多卡醇泡沫硬化剂闭合术与腔内激光闭合术治疗轻中度下肢静脉曲张的疗效对比  

Comparison of polidocanol foam sclerotherapy and endovenous laser treatment for mild and moderate lower extremity varicosis

作　　者：陶悦 范隆华 李旭 房林[4] TAO Yue, FAN Longhua, LI Xu, FANG Lin.(Tongji University School of Medicine, Shanghai 200092, Chin)

机构地区：[1]同济大学医学院,上海200092 [2]复旦大学附属中山医院血管外科 [3]复旦大学附属中山医院青浦分院血管外科 [4]同济大学附属第十人民医院普外科

出　　处：《上海医学》2018年第1期19-23,共5页Shanghai Medical Journal

摘　　要：目的比较聚多卡醇泡沫硬化剂闭合术与腔内激光闭合术治疗轻中度下肢静脉曲张的疗效。方法选取2015年2—3月间复旦大学附属中山医院青浦分院收治的临床-病因学-解剖学-病理生理学分级系统(CEAP分级)C2、C3级下肢静脉曲张患者80例,共80条患肢,根据不同的治疗方法,将患者随机分成泡沫硬化剂组和腔内激光组,每组40例。泡沫硬化剂组行下肢曲张静脉聚多卡醇泡沫硬化剂闭合术,腔内激光组行腔内激光闭合术。术后2周和1、3、6个月门诊随访,比较两组患者的一般情况、手术时间、穿刺点数量、住院时间、治疗费用、早期有效性、术后再通情况和术后并发症情况(血栓性静脉炎、皮肤色素沉着、皮肤灼伤、皮肤感觉异常、术后残留曲张静脉)。结果泡沫硬化剂组患者单条患肢注入泡沫硬化剂(8.4±3.2)mL;腔内激光组患者大隐静脉主干使用激光能量为(2 047±498)J,分支使用激光能量为(581±405)J。泡沫硬化剂组的手术时间显著短于腔内激光组(P<0.05),穿刺点数量显著少于腔内激光组(P<0.05)。泡沫硬化剂组(患者可门诊治疗不住院,为便于统计随访,均安排其住院1d)的术后住院天数和治疗总费用均显著少于腔内激光组(P值均<0.05)。两组间患者术后早期治疗有效率、术后并发症发生率和术后再通率的差异均无统计学意义(P值均>0.05)。腔内激光组的皮肤色素沉着发生率显著低于泡沫硬化剂组(P<0.05),皮肤感觉异常发生率显著高于泡沫硬化剂组(P<0.05);两组间血栓性静脉炎、皮肤灼伤、术后残留曲张静脉发生率的差异均无统计学意义(P值均>0.05)。结论聚多卡醇泡沫硬化剂闭合术与腔内激光闭合术治疗轻中度下肢静脉曲张的近期疗效相当,泡沫硬化剂治疗的手术时间、穿刺点数量、住院时间、治疗费用均优于腔内激光闭合术,值得临床推广。Objective To compare the effect between polidocanol foam sclerotherapy and endovenous laser treatment for mild and moderate lower extremity varicosis. Methods A total of 80 patients （80 limbs） with mild and moderate lower extremity varicosis （clinical-etiology-anatomic-pathophysiologic classification system [CEAP7 C2 to C3） admitted to Zhongshan Hospital Qingpu Branch from February 2015 to March 2015 were enrolled in this study. They underwent polidocanol foam sclerotherapy （observation group, n = 40） or endovenous laser treatment （control group, n = 40）. The patients were followed up on 2 weeks and 1, 3 and 6 months after operation. The general conditions, operation time, puncture frequency, hospitalization time, treatment costs, early effectiveness, postoperative recanalization and complications （thrombophlebitis, skin pigmentation, skin burns, skin paresthesia, residual varicose veins） were compared between the two groups. Results The mean injected dose of polidocanol was （8.4 ± 3.2） mL. The laser energy used in the trunk and branch of the great saphenous vein was （2 047± 498） J and （581 ± 405） J, respectively. Compared with those in the control group,the operation time, puncture points, postoperative hospitalization days and total treatment costs in the observation group were significantly decreased （all P〈0.05）. There was no significant difference in early effectiveness rate, postoperative complication rate or postoperative recanalization rate between the two groups （all P〉0.05）. The incidence of skin pigmentation in the control group was significantly lower than that in the observation group, while the incidence of skin paresthesia in the control group was significantly higher than that in the observation group （both P〈0.05）. There was no significant difference in the incidence of thrombophlebitis, skin burns or residual varicose veins between the two groups （all P〉0.05）. Conclusion The short-term effect of polidocanol foam sclerotherapy is similar

关 键 词：聚多卡醇 泡沫硬化剂 激光 下肢静脉曲张 

分 类 号：R654.4[医药卫生—外科学]