SEPS联合泡沫硬化剂治疗下肢静脉性溃疡的效果分析  

Analysis of the Effect of SEPS Combined with Foam Sclerotherapy on Venous Ulcer of Lower Extremities

作　　者：吕渐成 严琨 张崇杰 张新 马文博 LÜJiancheng;YAN Kun;ZHANG Chongjie;ZHANG Xin;MA Wenbo(Department of General Surgery, Weifang No.2 People’s Hospital, Weifang Shandong 261041, China)

机构地区：[1]潍坊市第二人民医院普外科,山东潍坊261041

出　　处：《河南医学高等专科学校学报》2020年第6期606-609,共4页Journal of Henan Medical College

摘　　要：目的探讨腔镜深筋膜下交通支离断术(subfascial endoscopic perforators surgery,SEPS)联合泡沫硬化剂治疗下肢静脉性溃疡的优点、效果及临床意义。方法回顾性分析下肢静脉性溃疡患者80例临床资料,按手术方式分为观察组与对照组,各40例。观察组行SEPS联合静脉泡沫硬化剂注射治疗,对照组行患侧大隐静脉高位结扎并点式抽剥及Linton手术。比较2组围术期指标、术后并发症及溃疡愈合时间。结果2组术后浅静脉曲张均消失,差异无统计学意义(P>0.05)。观察组与对照组比较:手术时间[(45.0±5.1)min vs(63.0±4.2)min],术中出血量[(15.0±3.2)mL vs(25.0±2.4)mL],术后住院时间[(7.0±2.1)d vs(12.0±4.2)d],下肢皮肤溃疡愈合时间[(20.15±2.01)d vs(32.25±2.21)d],差异均有统计学意义(P<0.05)。2组患者均随访36个月,未见复发。观察组2例患者出现小腿皮下血肿,给予切开引流后痊愈,无皮肤坏死、切口感染、溃疡复发及深静脉血栓形成(DVT)。结论SEPS联合泡沫硬化剂治疗下肢静脉性溃疡效果较满意,可避免和减少术后复发,并发症少,且有微创美容效果。Objective To investigate the advantages,effects and clinical significance of subfascial endoscopic perforators surgery(SEPS)combined with foam sclerotherapy in the treatment of venous ulcers of lower extremities.Methods 80 patients with venous ulcer of lower extremity were divided into the observation group and the control group by retrospective analysis according to the operation method,40 cases in each group.The observation group was treated with SEPS combined with intravenous foam sclerotherapy,and the control group was treated with high ligation of the ipsilateral great saphenous vein with point stripping and Linton surgery.The perioperative indicators,postoperative complications and ulcer healing time of the two groups were compared.Results The superficial varicose veins disappeared in 2 groups after operation,the difference was not statistically significant(P>0.05).Compared with the control group,the operation time[(45.0±5.1)min vs(63.0±4.2)min],intraoperative blood loss[(15.0±3.2)mL vs(25±2.4)mL],postoperative hospital stay[(7.0±2.1)d vs(12.0±4.2)d],and healing time of skin ulcer of lower extremities[(20.15±2.01)d vs(32.25±2.21)d],the differences were not statistically significant(P<0.05).After 36 months follow-up,no case had a recurrence.2 patients developed subcutaneous hematoma of the calf,which were cured after incision and drainage without skin necrosis,incision infection,ulcer recurrence and deep vein thrombosis(DVT).Conclusion The effect of SEPS combined with foam sclerotherapy on venous ulcers of the lower extremity is satisfactory,which can avoid and reduce postoperative recurrence,decrease complications and has minimally invasive cosmetic effect.

关 键 词：静脉性溃疡 腔镜 交通支离断术 泡沫硬化剂 

分 类 号：R658.3[医药卫生—外科学]