激光闭合联合泡沫硬化剂注射术与大隐静脉剥脱术治疗下肢静脉曲张的短期疗效比较  

Short-term clinical effect comparison between laser combined with foam sclerotherapy and stripping of great saphenous veinin treating lower

作　　者：董波[1] 洪彪[1] 王珏 王夕栩 汪恒 龚亦群 王暐 DONG Bo;HONG Biao;WANG Jue;WANG Xi-xu;WANG Heng;GONG Yi-qun;WANGWei(Department of Vascular Surgery,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336,China)

机构地区：[1]上海交通大学医学院附属同仁医院血管外科,上海200336

出　　处：《中国现代普通外科进展》2018年第10期791-794,815,共5页Chinese Journal of Current Advances in General Surgery

基　　金：上海市卫生和计划生育委员会科研项目(201440430);上海交通大学医学院附属同仁医院院级项目(TR201411)

摘　　要：目的:前瞻性随机对照试验比较激光闭合联合泡沫硬化剂注射术与大隐静脉剥脱术治疗下肢静脉曲张的疗效。方法:2015年1月—2016年12月在我院治疗大隐静脉曲张患者220例(患肢289条),随机分组后分别采用激光闭合联合泡沫硬化剂治疗术(A组,110例)和大隐静脉剥脱术(B组,110例)进行治疗。比较两组手术时间、住院时间、不同时间点临床严重程度评分及CEAP分级、不同时间点超声检测大隐静脉主干闭合情况和反流情况等。结果:A组在手术时间、术后平均恢复时间等方面均较B组有所缩短,且差异有统计学意义(P <0.05);A组术后隐神经损伤、皮下血肿、瘀斑等并发症也较B组明显减少。术后随访两组CEAP分级及临床严重程度评分均较术前明显降低,再通率均较低,且均无完全未闭塞发生。结论:与大隐静脉剥脱术相比,激光闭合联合泡沫硬化剂注射术治疗下肢静脉曲张可以缩短手术时间、术后恢复时间,减少术后并发症,并取得相同的治疗效果。Objective： To conduct a prospective randomized controlled clinical trial so as tocompare the efficacy difference between two therapeutic regimens in treating lower extremitiesvaricose veins. The two regimens are respectively the laser combined with foam sclerotherapy（thelaser foamsclerotherapy for short） and the stripping of great saphenous vein （the stripping techniquefor short）. Methods： Take a total of 220 cases （289 affected limbs） of lower extremities varicoseveins as subjects. They were treated in Tongren Hospital during the period from January 2015 andDecember 2016. They were randomly and evenly divided into two groups： 110 cases as Group Atreated by the laser foam sclerotherapy and the remaining 110 cases as Group B treated by thestripping technique. Based on clinical standards and literature review, the trial involved indexes asfollows： operating time, recovery time, post-treatment complications, clinical severity score, CEAPclassification and relapse such as the trunk occlusion of the great saphenous vein and reflux on differenttime points. Results： Group A patients’operating time and recovery time were obviouslyshorter than Group B （ 〈0.05）, with statistical significance. And they showed fewer post-treatmentcomplications like saphenous nerve injury, subcutaneous hematoma and skin scald. Both groups hadreached clinical cure standard, CEAP classification and clinical severity score decreasing sharply,vessel repass rate being low, and no occurrence of incompetence. But no significant difference wasdiscovered in terms of the follow-up. Conclusion： The laser foam sclerotherapy is as effective asthe stripping technique and has shown superiority in shortening operating and recovery time and inreducing post-treatment complications.

关 键 词：下肢静脉曲张 静脉剥脱术 激光闭合术 泡沫硬化剂注射术 

分 类 号：R543.6[医药卫生—心血管疾病]