不同方式处理交通支静脉对下肢静脉性溃疡患者术后生活质量的影响  

Study on effect of different treatments for perforating veins of patients with venous leg ulcers on their postoperative quality of life

作　　者：孔令尚[1] 丁家骏 金辉 丁洋[1] 叶琨[1] 万圣云[1] KONG Ling-shang;DING Jia-jun;JIN Hui;DING Yang;YE Kun;WAN Sheng-yun(Department of Vascular Surgery,theSecond Hospital of Anhui Medical University,Hefei 230601,China;Department of Orthopaedics,Hefei Orthopedic Hospital,Anhui,Chaohu 238000,China)

机构地区：[1]安徽医科大学第二附属医院血管外科,合肥230601 [2]合肥市骨科医院骨科,安徽巢湖238000

出　　处：《中国医学前沿杂志（电子版）》2019年第6期83-86,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2017年国家自然科学基金(面上项目)(81770483);2017年安徽医科大学校科研基金项目(2017xkj030)

摘　　要：目的探讨下肢交通支静脉腔镜离断(subfascial endoscopic perforator surgery,SEPS)、泡沫硬化剂注射(foam sclerotherapy,FS)和手术结扎三种方式治疗下肢静脉性溃疡,患者术后短期并发症和生活质量的差异。方法选取安徽医科大学第二附属医院血管外科2017年10月至2018年10月收治的小腿交通支静脉功能不全的下肢静脉性溃疡患者60例,采用随机数表法将其分为SEPS组、FS组和手术结扎组,每组各20例。比较三组患者术后短期疗效、并发症情况及生活质量的差异。结果术后1周,超声显示三组患者交通支静脉均完全闭合,溃疡面均改善;FS组患者术后皮下血肿、皮肤麻木的发生率最低,皮下硬结发生率最高(均P<0.05),三组患者静脉血栓发生率比较无显著差异(P>0.05);FS组患者术后疼痛发生率及静脉临床严重程度评分均显著低于另外两组(均P<0.05),术后SF-36量表生理功能维度评分均显著高于另外两组(均P<0.05)。结论SEPS、FS和手术结扎治疗下肢静脉性溃疡,FS术后并发症较少,且患者术后生活质量最高。Objective To investigate the short-term complications and quality of life of lower extremity venous ulcers after the treatment of subfascial endoscopic perforator surgery (SEPS),foam sclerotherapy (FS) and surgical ligation.Method From October 2017 to October 2018,60 patients with venous leg ulcers of the lower extremities with venous insufficiency admitted to the Department of Vascular Surgery,Second Affiliated Hospital of Anhui Medical University from October 2017 to October 2018 were selected.They were divided into SEPS group,FS group and surgical ligation group by random number table method,20 cases in each group.The short-term efficacy,complications and quality of life of the three groups were compared.Result One week after the operation,the ultrasound showed that the communication veins of the three groups were completely closed and the ulcer surface was improved.The incidence of subcutaneous hematoma and skin numbness were the lowest in FS group,and the incidence of subcutaneous induration was the highest in FS group (all P < 0.05).There was no significant difference in the incidence of venous thrombosis between the three groups (P > 0.05).Postoperative pain rate and venous clinical severity score in FS group were significantly lower than those in the other two groups (all P < 0.05).Physiological function dimension score of SF-36 scale in FS group was significantly higher than that in the other two groups (all P < 0.05).Conclusion The efficacy of SEPS,FS and surgical ligation in the treatment of venous leg ulcers,but the postoperative complications of FS are less and the postoperative quality of life is the highest.

关 键 词：下肢静脉性溃疡 交通支静脉腔镜离断 泡沫硬化剂注射 

分 类 号：R654.4[医药卫生—外科学]