腔内激光微创治疗下肢静脉曲张的临床效果  

Effects of endovenous laser ablation technique for large saphenous varicose veins:an analysis in 248 cases

作　　者：彭艳斌[1] 褚云峰[1] 陈仲 万圣祥[1] 肖颖峰[1] PENG Yan-bin;CHU Yun-feng;CHEN Zhong;WAN Shen-xiang;XIAO Ying-feng(Hand Microsurgery,Shenzhen Hospital,Peking University,Shenzhen,Guangdong 518036,China)

机构地区：[1]北京大学深圳医院手显微外科,广东深圳518036

出　　处：《岭南现代临床外科》2020年第2期210-213,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨腔内激光微创治疗下肢静脉曲张的临床效果。方法选取2012年7月到2019年12月在我院完成的经静脉腔内激光消融治疗下肢大隐静脉曲张248例(激光消融组),另选取同期在我院收治采用传统大隐静脉高位结扎术+抽剥术治疗患者248例(传统手术组),对比两组患者的治疗效果。结果激光消融组在切口长度、手术时间、术后第一天疼痛程度及持续时间及住院时间均好于常规手术组(P均<0.05);并发症主要包括切口延迟愈合、创口血肿、皮肤麻木、皮下硬结及静脉腔内热引发血栓形成,激光消融组的发生率明显低于常规手术组(P均<0.05);随访12个月,激光消融组有14例(5.6%)复发,常规手术组有8例(3.2%)复发,两组间差异没有统计学意义(P>0.05);激光消融组患者生活质量评分(SF-36)明显优于常规手术组(P<0.05)。结论腔内激光微创治疗在改善下肢静脉曲张患者病情方面可发挥积极作用。Objective To investigate the clinical effect of intracavitary laser minimally invasive treatment of varicose veins of lower extremities.Methods From July 2012 to December 2019,248 patients(laser ablation group)with varicose great saphenous vein of lower extremities were treated by endovenous laser ablation in our hospital,and another 248 patients(traditional operation group)were treated by traditional high ligation of great saphenous vein plus extraction at the same time in our hospital.The clinical effects were compared between the two groups.Results The incision length,operation time,first day postoperative pain degree,duration and hospitalization time of laser ablation group were better than those of conventional operation group(all P values<0.05).The complications mainly included delayed healing of incision,hematoma of wound,numbness of skin,subcutaneous induration and thrombosis caused by heat in vena cava.The incidence of laser ablation group was significantly lower than that of conventional operation group(all P values<0.05).After 12 months follow-up,14 cases(5.6%)recurred in the laser ablation group and 8 cases(3.2%)recurred in the conventional operation group.There was no significant difference between the two groups(P>0.05).The quality of life score(SF-36)in the laser ablation group was significantly better than that in the conventional operation group(P<0.05).Conclusion Intraluminal laser minimally invasive treatment can play an active role in improving the condition of patients with varicose veins of lower extremities,which is worthy of popularization and application.

关 键 词：腔内激光微创治疗 高位结扎剥脱术 下肢静脉曲张 疼痛程度 并发症 

分 类 号：R654.4[医药卫生—外科学]