氰基丙烯酸正丁酯医用胶联合硬化剂治疗原发性大隐静脉曲张的早期疗效和安全性分析  

N-butyl cyanoacrylate medical glue embolization combined with sclerotherapy in the treatment of primary great saphenous vein varicose

作　　者：张明逸 喻武 冉坤 李瑞豪 喻诗雄 汪海洋[1] 孙建明[1] 唐博[1] 陈以宽[1] Zhang Mingyi;Yu Wu;Ran Kun;Li Ruihao;Yu Shixiong;Wang Haiyang;Sun Jianming;Tang Bo;Chen Yikuan(Department of Vascular Surgery,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院血管外科,重庆400010

出　　处：《中国血管外科杂志（电子版）》2021年第2期111-115,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金面上项目(81470583);重庆医科大学附属第二医院“宽仁英才”项目。

摘　　要：目的探讨国产氰基丙烯酸正丁酯(n-butyl cyanoacrylate,n-BCA)医用胶联合硬化剂治疗原发性大隐静脉曲张的早期疗效和安全性。方法回顾性收集2020年5月至2021年1月重庆医科大学附属第二医院53例(62条患肢)采用国产n-BCA医用胶联合硬化剂治疗原发性大隐静脉曲张的患者临床资料,分析其技术细节、近期疗效和安全性。结果患者均顺利完成手术,技术成功率100%。术后3~7 d大隐静脉闭合率为96.8%(60/62)。49例患者(57条患肢)在术后3个月完成随访,大隐静脉主干闭合率为96.5%(55/57),静脉临床严重程度评分显著低于术前[(1.9±1.3)分vs(6.1±2.3)分,P<0.001],慢性下肢静脉功能不全生活质量评分显著高于术前[(76.2±3.1)分vs(63.7±4.7)分,P<0.001],生活质量显著改善。患者均无发生症状性肺栓塞和患肢感染。17例(27.4%)患者穿刺点周围出现局部瘀斑,9例(14.5%)患者出现类静脉炎样反应,均在2~4周后自行消退。1例患者出现严重过敏反应。1例患者术后第3天发生胫后静脉血栓形成。结论应用国产n-BCA医用胶联合硬化剂治疗原发性大隐静脉曲张的近期疗效满意,安全可靠。Objective To investigate the short-term efficacy and safety of domestic n-butyl cyanoacrylate(n-BCA)medical glue combined with sclerotherapy in the treatment of primary great saphenous vein varicose.Methods The clinical data of 53 primary great saphenous vein varicose patients(62 limbs)who treated with domestic n-BCA medical glue combined with sclerotherapy in the Second Affiliated Hospital of Chongqing Medical University from May 2020 to January 2021 were collected retrospectively.We analyzed its technical details,short-term therapeutic efficacy and safety.Results All patients completed the operation successfully,and the technical success rate was 100%.The closure rate of the great saphenous vein was 96.8%(60/62)in 3~7 days after operation.49 patients(57 limbs)completed the follow-up at three months after operation,and the closure rate of the great saphenous vein was 96.5%(55/57).The venous clinical severity score was significantly lower than that before surgery[(1.9±1.3)points vs(6.1±2.3)points,P<0.001],and the chronic venous insufficiency quality of life questionnaire score was significantly higher than that of preoperative[(76.2±3.1)points vs(63.7±4.7)points,P<0.001].Patients’quality of life was significantly improved.No symptomatic pulmonary embolism or limb infection occurred.Seventeen patients(27.4%)had local ecchymosis around the puncture point,and 9 patients(14.5%)had phlebitis-like reactions,which all resolved spontaneously after 2 to 4 weeks.One patient had a severe allergic reaction.One patient developed posterior tibial venous thrombosis on the third day after operation.Conclusion The short-term effect of domestic n-BCA medical glue combined with sclerotherapy in the treatment of primary great saphenous vein varicose is satisfactory,and the safety is reliable.

关 键 词：医用胶 氰基丙烯酸正丁酯 硬化剂 静脉曲张 大隐静脉 

分 类 号：R654.4[医药卫生—外科学]