老年下肢静脉曲张患者两种联合微创手术方式对比分析  

Comparative analysis of two combined minimally invasive surgery methods in elderly patients with varicose veins

作　　者：刘万里 宋燕[1] 苗仁英 齐超然 张一飞 孙悦[1] 张志敏 LIU Wan-li;SONG Yan;MIAO Ren-ying;QI Chao-ran;ZHANG Yi-fei;SUN Yue;ZHANG Zhi-min(Department of Macrovascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院大血管外科,郑州450052

出　　处：《医药论坛杂志》2020年第11期9-12,17,共5页Journal of Medical Forum

基　　金：河南省高等学校重点科研项目(21A320042)。

摘　　要：目的对比分析大隐静脉射频消融(radiofrequency ablation,RFA)联合硬化剂栓塞硬化+点式剥脱术与大隐静脉高结扎并剥离结合经皮光微创旋切术(TriVex)治疗老年下肢静脉曲张(great saphenous vein varices,GSV)患者的临床疗效。方法回顾性分析2018年8月至2020年5月在郑大学第一附属医院血管外科收治的326例GVS(C1~C4)老年患者的临床资料。依据纳入和排除标准,最终选择240例单腿GVS患者。按术式不同进行分组,其中研究组120例行RFA联合泡沫硬化剂栓塞+点式剥脱术,对照组120例行大隐静脉高结扎并剥离结合经皮光微创旋切术(TriVex)。比较两组患者的总体住院天数,手术前后的血红蛋白变化,术后输液,术后早期下床活动时间,术后并发症,以及术后1、3、 6个月和1年的复发情况进行分析。结果研究组总住院天数,手术前后血红蛋白变化,术后输液,术后早期下床活动时间,术后并发症对比少于对照组(P<0.05)。患者术后1、3、6个月和1年未见复发。结论对于老年GVS(C1~C4)患者,RFA联合泡沫硬化剂栓塞硬化+点式剥脱术在缩短住院时间,减少术后补液量,减少术后并发症和安全性方面明显优于大隐静脉高结扎并剥离结合经皮光微创旋切术(TriVex)。Objective To compare and analyze the great saphenous vein radiofrequency ablation(RFA) combined with sclerotherapy embolization + point stripping and the great saphenous vein high ligation and stripping combined with percutaneous light minimally invasive atherectomy(TriVex) for the treatment of elderly varicose veins( Great saphenous vein varices, GSV) the clinical efficacy of patients.Methods The clinical data of 326 elderly patients with GVS(C1~C4) admitted to the Department of Vascular Surgery, the First Affiliated Hospital of Zhengzhou University from August 2018 to May 2020 were retrospectively analyzed. According to the inclusion and exclusion criteria, 240 single-leg GVS patients were finally selected. According to different surgical procedures, 120 patients in the study group underwent RFA combined with foam sclerosing agent embolization + point stripping, and 120 patients in the control group underwent high saphenous vein ligation and stripping combined with percutaneous light minimally invasive atherectomy(TriVex). The overall hospital stay of the two groups of patients, changes in hemoglobin before and after surgery, postoperative fluid infusion, early postoperative time of getting out of bed, postoperative complications, and recurrence at 1, 3, 6 months and 1 year after surgery were analyzed.Results The total number of days of hospitalization in the study group, changes in hemoglobin before and after surgery, postoperative fluid infusion, early postoperative time to get out of bed, and postoperative complications were less than the control group(P<0.05). There was no recurrence at 1, 3, 6 months and 1 year after the operation.Conclusion For elderly patients with GVS(C1~C4), RFA combined with foam sclerosing agent embolization sclerotherapy + point peeling is significantly better than the great saphenous vein in shortening the hospital stay, reducing the amount of postoperative fluid rehydration, reducing postoperative complications and safety. Ligation and stripping combined with percutaneous light mi

关 键 词：射频消融 下肢静脉曲张 TRIVEX 

分 类 号：R543[医药卫生—心血管疾病]