超声定位及肿胀麻醉下腔内激光闭合术联合泡沫硬化剂注射治疗下肢浅静脉曲张25例报告  

EVLT combined with FST assisted by ultrasound-guided and tumescent anesthetic solution in treating varicose veins in lower extremities:report of 25 cases

作　　者：叶波[1] 陈伟清[1] 蒙斌 郑国富[1] 刘小春[1] 谢海亮 张滕 YE Bo;CHEN Wei-qing;MENG Bin;ZHENG Guo-fu;LIU Xiao-chun;XIE Hai-liang;ZHANG Teng(Department of Vascular Surgery,Ganzhou People's Hospital;Department of General Surgery,Second People's Hospital of Nankang District,Ganzhou,Jiangxi 341000)

机构地区：[1]赣州市人民医院血管疝外科 [2]赣州市南康区第二人民医院普外科,江西赣州341000

出　　处：《赣南医学院学报》2020年第10期1015-1017,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省卫生健康委员会普通科技计划项目(编号:20204629)。

摘　　要：目的:总结超声定位及肿胀麻醉下腔内激光闭合术联合泡沫硬化剂注射治疗下肢浅静脉曲张的安全性和临床疗效。方法:选择2019年1月至2020年2月,在赣州市人民医院接受超声定位及肿胀麻醉下腔内激光闭合联合泡沫硬化剂注射治疗下肢静脉曲张患者25例。其中,男11例,女14例,年龄32~67岁,平均(43.3±6.9)岁;单侧18例,双侧7例;共32条肢体按CEAP分级:C2级6条,C3级17条,C4级9条;所有均采用超声定位及肿胀麻醉下腔内激光闭合术联合泡沫硬化剂注射术式治疗。结果:所有患者术中顺利,术中疼痛VAS评分(3.2±0.35)分。术后随访半年,痊愈16例占64%,有效9例占36%,总有效率100%。其中,皮肤局部过敏3例、皮肤轻度烧伤4例、隐神经烧伤2例,患者无感染和近期复发等严重并发症。结论:在腔内激光联合泡沫硬化治疗下肢浅静脉曲张中,应用超声定位及肿胀麻醉有助于减轻术中疼痛,操作精准,疗效安全、可靠。Objective:To investigate the clinical efficacy and safety of EVLT combined with FST assisted by ultrasoundguided and tumescent anesthetic solution in treating varicose veins in lower extremities.Methods:From January 2019 to February 2020,25 cases with varicose veins of lower extremities were treated by the combined minimally invasive surgery.There were 11 males and 14 females with an average age of(43.3±6.9)years(range,32-67 years),and 8 unilateral limbs and 7 bilateral limbs.According to CEAP classification,there were 6 C2 limbs,17 C3 limbs and 9 C4 limbs.All patients were treated with endovenous laser treatment(EVLA)combined with foam sclerotherapy(FST)assisted by ultrasound-guided and tumescent anesthetic solution.Results:The intraoperative VAS scores of 25 patients was 3.2±0.35.Meanwhile,after 6 months of follow-up,16 cases(64%)were cured,9 cases(36%)were effective,and the total effective rate was 100%.Furthermore,the complication of this group included 3 cases with local skin allergy,4 cases with mild skin burn and 2 cases with saphenous nerve burn.But no case with infection and recent recanalization.Conclusion:In the process of EVLA combined with FST assisted by ultrasound-guided and tumescent anesthetic solution for varicose veins of lower extremities.It is helpful to reduce the pain during the operation;the operation is accurate;the curative effect is safe and reliable.

关 键 词：下肢浅静脉曲张 超声定位 肿胀麻醉 微创联合手术 

分 类 号：R543.6[医药卫生—心血管疾病]