激光闭合联合硬化剂注射用于大隐静脉曲张治疗的疗效及安全性研究  

Efficacy and safety of laser closure combined with sclerosing agent injection in the treatment of varicose great saphenous vein

作　　者：陈海瑞 张剑平 王孝高[2] 王颖 余朝文[2] 卢冉[2] 陈世远[2] 孙勇[2] 官泽宇[2] CHEN Hairui;ZHANG Jianpin;WANG Xiaogao;WANG Ying;YU Chaowen;LU Ran;CHEN Shiyuan;SUN Yong;GUAN Zeyu(Department of Vascular Surgery,Taihe County People′s Hospital,Fuyang,Anhui 236000,China;Department of Vascular Surgery,First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]太和县人民医院血管外科,安徽阜阳236000 [2]蚌埠医学院第一附属医院血管外科,安徽蚌埠233004

出　　处：《重庆医学》2021年第16期2744-2747,2752,共5页Chongqing medicine

基　　金：安徽省教育厅重点项目(KJ2019A0327);蚌埠医学院自然科学基金重点项目(BYKY1862ZD);蚌埠医学院科技发展基金项目(BYKF1886)。

摘　　要：目的探讨激光闭合联合硬化剂注射用于大隐静脉曲张治疗的疗效及安全性。方法选取2015年1月至2017年1月太和县人民医院收治的大隐静脉曲张患者284例,采用抽签法分为观察组和对照组,各142例。观察组患者采用激光闭合联合硬化剂注射治疗,对照组采用传统手术治疗。比较两组手术时长、切口长度、切口数量、出血量、住院时间、术后并发症发生情况,手术前后血清白细胞介素(IL)-2、IL-10、肿瘤坏死因子-α(TNF-α),以及术后1、2、3年大隐静脉曲张复发率。结果观察组手术时间、切口数量、术中出血量明显低于对照组(P<0.001),切口长度、住院时间明显短于对照组(P<0.001)。观察组总并发症发生率明显低于对照组(5.63%vs.12.68%,P<0.05);术后观察组血清IL-2水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05)。观察组术后1、2、3年复发率分别为1.14%、4.93%、11.27%,对照组分别为2.11%、5.63%、10.56%,差异无统计学意义(P>0.05)。结论与传统手术相比,激光闭合联合硬化剂注射治疗大隐静脉曲张疗效较好,安全性更高,炎性反应程度低。Objective To explore the efficacy and safety of laser closure combined with sclerosing agent injection for treating varicose great saphenous vein.Methods A total of 284 patients with varicose great saphenous vein in Taihe County People′s Hospital from January 2015 to January 2017 were selected and divided into the observation group and control group by adopting the envelope method,142 cases in each group.The observation group adopted the laser closure combined with sclerosing agent injection,while the control group was treated with traditional surgery.The operation time,incision length,number of incisions,blood loss amount,hospital stay and postoperative complication occurrence,and levels of serum inflammatory factors before and after surgery,including interleukin(IL)-2,IL-10,and tumor necrosis factor-α(TNF-α),were compared between the two groups.The recurrence rates of varicose great saphenous vein in postoperative 1,2,3 years were compared between the two groups,as well.Results The operation time,number of incisions and intraoperative blood loss amount in the observation group were significantly lower than those in the control group(P<0.001),and the incision length and hospital stay were significantly shorter than those in the control group(P<0.001).The total incidence rate of complications in the observation group was significantly lower than that in the control group(5.63%vs.12.68%,P<0.05).The level of serum IL-2 after operation in the observation group was significantly lower than that in the control group,and the level of serum IL-10 was significantly higher than that in the control group,with statistically significant differences(P<0.05).The recurrence rates in postoperative 1,2,3 years were 1.14%,4.93%and 11.27%in the observation group and 2.11%,5.63%and 10.56%in the control group,respectively,no statistically significant difference was found between the two groups(P>0.05).Conclusion Compared with traditional surgery,laser closure combined with sclerosing agent injection for treating varicose great sa

关 键 词：大隐静脉曲张 激光闭合 硬化剂注入疗法 复发率 安全性 

分 类 号：R654.4[医药卫生—外科学]