改良法注射聚桂醇泡沫硬化剂治疗大隐静脉曲张的疗效观察  

Curative effect of modified injection of polyvinyl alcohol foam hardening agent on varicose great saphenous vein

作　　者：孙厚坦 赵威武 陈朝旻 田博 李涵哲 李秦 SUN Houtan;ZHAO Weiwu;CHEN Zhaomin;TIAN Bo;LI Hanzhe;LI Qin(Department of Ultrasound Diagnosis,the 940th Hospital of Joint Logistic Support Force of PLA, Lanzhou 730050,China;Xi′an International Medical Center Hospital)

机构地区：[1]解放军联勤保障部队第940医院超声诊断科,甘肃兰州730050 [2]西安国际医学中心医院

出　　处：《西北国防医学杂志》2020年第11期677-681,共5页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省卫生行业科研计划项目(GSWSKY-2019-20)。

摘　　要：目的:观察超声引导下改良法注射聚桂醇泡沫硬化剂治疗大隐静脉曲张的疗效,探讨其安全性、有效性及临床应用价值。方法:选择我院收治的大隐静脉曲张患者156例,随机分为观察组和对照组,每组78例。对照组在大腿根部扎止血带2根,用一次性静脉头皮针分次多点穿刺入大隐静脉主干,分段注入聚桂醇泡沫硬化剂,另用一次性静脉头皮针分次多点穿刺入膝关节水平以下的曲张静脉内注入聚桂醇泡沫硬化剂;观察组在大腿根部扎止血带2根,并按照治疗顺序依次在大腿中部、膝关节上方、膝关节下方、小腿中部、踝关节上方各扎止血带1根,将注射部位分成4个,注射聚桂醇泡沫硬化剂约5 ml,作用3~5 min后再抽出。对比两组手术治疗有效率、优良率及不良反应发生率。结果:两组治疗有效率均为100.00%。观察组优良率为92.30%,高于对照组的83.33%(P<0.05);对照组23例(29.49%)治疗后感到胸闷、咳嗽,观察组未出现此类症状;对照组46例(58.97%)术后发生静脉血管内硬结,观察组5例(6.41%)术后发生静脉血管内硬结。结论:在超声引导下注射聚桂醇泡沫硬化剂治疗大隐静脉曲张过程中,采用改良法注射疗效显著,降低了术后复发率及并发症发生率,值得推广应用。Objective:To observe the efficacy of ultrasound-guided modified injection of polyvinyl alcohol foam hardening agent on varicose great saphenous vein,and to evaluate its safety,efficacy and clinical application.Methods:A total of 156 patients with varicose great saphenous vein admitted to our hospital were randomly divided into the observation group and the control group,78 cases in each group.In the control group,two tourniquets were placed at the thigh root,the main trunk of the great saphenous vein was punctured several times with a single intravenous scalp needle,and polyvinyl alcohol foam hardening agent was injected in sections,a single intravenous scalp needle was used to puncture the varicose vein below the knee level for injection with polyvinyl alcohol foam hardening agent.In the observation group,two tourniquets were placed at the thigh root,and one tourniquet was placed at the middle of thigh,the upper part of knee,the lower part of knee,the middle part of leg,and the upper part of ankle respectively according to the treatment sequence.The injection site was divided into four parts,the scalp needle below begins to injecting the polyvinyl alcohol foam hardening agent about 5 ml for 3-5 min.The effective rate,excellent rate and adverse reaction rate between the two groups were compared.Results:The effective rate of the two groups was 100.00%.The excellent rate was 92.30%in the observation group,which was higher than that in the control group 83.33%(P<0.05).23 patients(29.49%)felt chest tightness and cough after treatment in the control group,but no such symptoms occurred in the observation group.46 patients(58.97%)in the control group and 5 patients(6.41%)in the observation group developed induration in venous blood tubes.Conclusion:In the treatment of varicose great saphenous vein under ultrasound-guided injection of polyvinyl alcohol foam hardening agent,the improved method is more effective,it can reduce the incidence of postoperative recurrence and complications,and worth popularizing.

关 键 词：超声 大隐静脉曲张 聚桂醇泡沫硬化剂 介入治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]