不同麻醉方式下VNUS联合点式剥脱术治疗大隐静脉曲张的临床效果  

Clinical effect of VNUS combined with point stripping under different anesthesia methods in the treatment of varicosis of great saphenous vein

作　　者：强群[1] 盛丽[1] 刘佳[1] 李亮[2] 唐晓勇[2] 霍树靓[1] QIANG Qun;SHENG Li;LIU Jia;LI Liang;TANG Xiao-yong;HUO Shu-liang(Ultrasound Medical Imaging Department,Gansu Provincial Hospital of TCM,Lanzhou 730050,China;No.1 Surgery Department,Gansu Provincial Hospital of TCM,Lanzhou 730050,China)

机构地区：[1]甘肃省中医院超声医学影像科,甘肃兰州730050 [2]甘肃省中医院外一科,甘肃兰州730050

出　　处：《临床医学研究与实践》2019年第31期16-18,共3页Clinical Research and Practice

基　　金：甘肃省卫生行业科研计划项目（No.GSWSKY-2015-14）

摘　　要：目的比较两种麻醉方式下行射频闭合(VNUS)联合点式剥脱术治疗大隐静脉曲张的临床效果,探讨在超声监测下应用局部浸润麻醉行大隐静脉曲张治疗术的可行性,为开创日间手术模式提供参考。方法选择我院2014年1月至2016年12月收治的118例下肢大隐静脉曲张患者(155条患肢),术前应用超声行深静脉功能分级。采用完全随机分组法将患者分为试验组(超声引导下局部浸润麻醉行VNUS联合点式剥脱术)与对照组(超声引导下硬膜外麻醉行VNUS联合点式剥脱术),每组59例。比较两组的治疗效果。结果手术后,两组患者均痊愈出院,于术后7d复查彩超提示大隐静脉主干闭合部分完全闭合,无血流信号。试验组首次下床活动时间及完全恢复活动时间短于对照组(P<0.05)。术后第1天,试验组的VAS评分低于对照组(P<0.05)。试验组的恶心呕吐、深静脉血栓发生率及术后住院费用均低于对照组(P<0.05)。结论超声引导局部浸润麻醉与硬膜外麻醉下VNUS联合点式剥脱术治疗大隐静脉曲张均具有安全性及有效性,但行局部浸润麻醉的患者术后恢复时间短,疼痛少,住院成本低。Objective To compare the clinical effects of radiofrequency endovenous obliteration (VNUS) combined with point stripping under two anesthesia methods in the treatment of varicosis of great saphenous vein, and to investigate the feasibility of treatment for varicosis of great saphenous vein with local infiltration anesthesia under the monitoring of ultrasonography, so as to provide reference for the creation of daytime operation mode. Methods A total of 118 patients (155 affected limbs) with varicosis of lower extremities great saphenous vein admitted in our hospital from January 2014 to December 2016 were selected. The deep vein function was graded by ultrasonography before operation. The patients were divided into experimental group (ultrasound-guided local infiltration anesthesia + VNUS combined with point stripping) and control group (ultrasound-guided epidural anesthesia + VNUS combined with point stripping) by complete random grouping method, with 59 cases in each group. The therapeutic effects of the two groups were compared. Results After operation, the patients of both groups cured and discharged. At the 7th day after operation, color Doppler ultrasonography showed that the main closed part of great saphenous vein was completely closed, without blood flow signal. The first time of getting out of bed activity and the time of complete recovery of activity in the experimental group were shorter than those in the control group (P<0.05). At the first day after operation, the VAS score of the experimental group was lower than that of the control group (P<0.05). The incidences of nausea and vomiting, deep venous thrombosis and hospitalization expenses in the experimental group were lower than those in the control group (P<0.05). Conclusion VNUS combined with point stripping under ultrasound-guided local infiltration anesthesia and epidural anesthesia are safe and effective in the treatment of varicosis of great saphenous vein. However, the patients undergoing local infiltration anesthesia have short recovery tim

关 键 词：大隐静脉曲张 超声 局部浸润麻醉 硬膜外麻醉 

分 类 号：R654.4[医药卫生—外科学]