激光腔内凝固术对大隐静脉曲张患者应激反应及预后的影响  

Effect of laser coagulation for the stress response and prognosis of patients with varicose of great saphenous vein

作　　者：汪弢 杨宏宇[2] WANG Tao;YANG Hongyu(Department of Vascular Surgery, Jiangning Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Nanjing 211100, China;Department of Vascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province, Nanjing 210029, China)

机构地区：[1]南京医科大学附属江宁医院血管外科,江苏南京211100 [2]南京医科大学第一附属医院血管外科,江苏南京210029

出　　处：《中国医药导报》2018年第13期76-79,共4页China Medical Herald

摘　　要：目的探讨激光腔内凝固术对大隐静脉曲张患者应激反应及预后的影响。方法选择2014年7月~2017年1月南京医科大学附属江宁医院收治的大隐静脉曲张患者96例为研究对象,采用随机数字表法将其分为观察组和对照组,每组48例。对照组采用大隐静脉高位结扎+曲张静脉剥脱术,观察组采用激光腔内凝固术。比较两组患者手术相关指标(手术时间、切口数、术中出血量、术后住院时间)、手术前后应激反应、并发症及随访12个月的复发率。结果观察组手术时间、切口数、术中出血量、术后住院时间均明显低于对照组(P<0.01);术后3 d,观察组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)含量明显低于对照组(P<0.01),切口感染、局部血肿瘀斑、隐神经损伤麻木发生率明显低于对照组,差异有统计学意义(P<0.05);随访12个月,两组复发率比较,差异无统计学意义(P>0.05)。结论激光腔内凝固术有助于缓解大隐静脉曲张患者手术应激反应,促进患者恢复,减少术后并发症。Objective To explore the effects of laser coagulation for the stress response and prognosis of patients with varicose of great saphenous vein. Methods Ninety-six patients with varicosis of great saphenous vein admitted to Jiangning Hospital Affiliated to Nanjing Medical University from January 2014 to June 2017 were selected as research objects. They were divided into observation group and control group according to random number table, with 48 cases in each group. Patients in the control group received the high ligation of great saphenous vein and varicose vein exfoliation, while the observation group received the laser coagulation. The surgery-related indicators（operation time, number of incision, intraoperative blood loss, postoperative hospital stay）, stress response before and after operation, complications and the recurrence rate after follow-up for 12 months were compared between the two groups. Results The operation time, number of incision, intraoperative blood loss, postoperative hospital stay in the observation group were significantly lower than those in the control group（P〈0.01）. After operation for three days, the serum levels of interleukin-6（IL-6）, tumor necrosis factor-α（TNF-α） and NO in the observation group were significantly lower than those in the control group（P〈0.01）, and the incidence of incision infection, local hematoma ecchymosis, saphenous nerve dam age were lower than those in the control group（P〈0.05）. After 12 months of follow-up, the recurrence rate of the two groups was not statistically significant（P〉0.05）. Conclusion The laser coagulation can help relieve the surgical stress response, promote the recovery and reduce the postoperative complications in patients with varicosis of great saphenous vein.

关 键 词：大隐静脉 曲张 激光腔内凝固术 应激反应 

分 类 号：R654.4[医药卫生—外科学]