腔内激光消融联合点式剥脱术在下肢静脉曲张中的应用  

Application of intracavitary laser ablation combined with point stripping in the treatment of varicose veins of the lower extremities

作　　者：刘永庆[1] 王成宏[1] 童钟[1] Liu Yongqing;Wang Chenghong;Tong Zhong(Department of General Surgery,Hefei First People's Hospital,Anhui,Hefei 230061)

机构地区：[1]合肥市第一人民医院普外科,安徽合肥230061

出　　处：《现代科学仪器》2021年第3期186-190,共5页Modern Scientific Instruments

摘　　要：目的:探讨改良曲张静脉点式剥除术配合腔内激光在下肢静脉曲张治疗中的应用。方法:回顾性分析2017年1月~2019年12月收治的87例手术治疗的下肢静脉曲张患者的临床资料,其中有45例实施改良曲张静脉点式剥除术配合腔内激光治疗,记为A组;有42例实施常规大隐静脉高位结扎联合抽剥术治疗,记为B组。对比手术指标,临床疗效,术前、术后3个月下肢深静脉瓣膜功能变化,术后3个月深静脉瓣功能改善情况,术后并发症发生率。结果:A组手术耗时长于B组(P<0.05),但前者平均术中出血量、切口个数、术后住院时间与B组相比差异均无统计学意义(P>0.05);2组临床疗效分布对比差异显著(P<0.05),A组显效率高于B组(P<0.05);术后3个月2组VCT均缩短(P<0.05),Vmax均提高(P<0.05),且A组术后3个月VCT短于B组(P<0.05),Vmax高于B组(P<0.05);术后3个月2组深静脉瓣膜功能改善情况分布差异显著(P<0.05),且A组改善率明显高于B组(P<0.05);A组并发症发生率低于B组(P<0.05)。结论:对下肢静脉曲张患者采用改良曲张静脉点式剥除术配合腔内激光可延长手术时间,但是与常规术式的创伤相近,而前者疗效更佳,并且能够显著改善下肢深静脉瓣膜功能,保证术后恢复,安全性也更佳。Objective:To explore the application of modified varicocele point stripping combined with endovenous laser in varicose veins of lower extremities.Methods:The clinical data of 87 cases of varicose veins in the lower extremities treated by operation from January 2017 to December 2019 were retrospectively analyzed,and there were 45 cases treated with modified varicose venovenous peeling and intracavitary laser therapy as group A,then the remaining 42 cases were treated with conventional high saphenous vein ligation combined with stripping as group B.The surgical indexes,clinical efficacy,changes of venous valvular function before operation and after 3 months of operation,the improvement of deep venous valve function after 3 months of operation and the incidences of postoperative complications were compared.Results:The operative time in the A group was longer than the B group(P<0.05),and there were no significant differences in the average intraoperative blood loss,incision number and postoperative hospital stay between group A and group B(P>0.05).There was a significant difference in the distribution of clinical efficacy between the 2 groups(P<0.05),and the effective rate of group A was higher than group B(P<0.05).After 3 months of operation,VCT in the 2 groups shortened(P<0.05),Vmax increased(P<0.05),and VCT in group A was shorter than group B(P<0.05),and Vmax was higher than group B after 3 months of operation(P<0.05).There was a significant difference in the improvement of deep venous valve function between the 2 groups after 3 months of operation(P<0.05),and the improvement rate in group A was significantly higher than group B(P<0.05).The incidence of complications in group A was lower than group B(P<0.05).Conclusion:For the patients with varicose veins of lower extremity,the improved varicose vein point stripping combined with the intracavity laser can lengthen operation time,but it is similar to the trauma of routine operation,while the former has better effect,and it can significantly improve the function of

关 键 词：改良曲张静脉点式剥除术 腔内激光 下肢静脉曲张 

分 类 号：R658.3[医药卫生—外科学]