微波消融联合泡沫硬化剂治疗下肢静脉曲张溃疡的临床疗效研究  

Effectiveness of microwave ablation combined with foam sclerotherapy in treatment of varicose ulcer of lower extremity

作　　者：王刚[1] 刘振斌[1] 李梦虎[1] 王军[1] 卢增珍 卢庆威 雷章成 牛力 范子轩 Wang Gang;Liu Zhenbin;Li Menghu;Wang Jun;Lu Zengzhen;Lu Qingwei;Lei Zhangcheng;Niu Li;Fan Zixuan(Department of Ulcer and Vascular Surgery,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]天津中医药大学第一附属医院疮疡及周围血管外科,天津300193

出　　处：《中华血管外科杂志》2021年第2期111-115,共5页Chinese Journal of Vascular Surgery

基　　金：家医团队能力建设实践课题与适宜技术培训项目(JYZ202002)。

摘　　要：目的观察微波消融联合泡沫硬化剂治疗下肢静脉曲张溃疡的临床疗效。方法回顾性分析2017年1月至2019年1月天津中医药大学第一附属医院收治的60例下肢静脉曲张溃疡患者的临床资料,其中治疗组30例患者应用微波消融联合聚多卡醇泡沫硬化剂结合中药基础治疗,对照组30例应用中药基础治疗,随访6个月。比较两组间创面痊愈率、总有效率、静脉临床严重程度评分(VCSS)等的差异。结果治疗后6个月,治疗组患者创面痊愈率(83.3%)优于对照组(46.7%),差异有统计学意义(χ^(2)=8.864,P=0.003);治疗组总有效率(96.7%)高于对照组(83.3%),但差异无统计学意义(χ^(2)=1.667,P=0.197)。K-M生存分析显示溃疡愈合时间治疗组患者优于对照组。两组患者治疗后6个月的VCSS评分均较治疗前低,差异有统计学意义(t=21.850,t=10.582,P均<0.001),且治疗后6个月时治疗组VCSS评分低于对照组,差异有统计学意义(t=-2.145,P=0.036)。结论在基础治疗上联合微波消融及泡沫硬化剂治疗下肢静脉曲张溃疡安全、有效,可以促进溃疡愈合并改善患者术后VCSS评分。Objective To evaluate the efficacy of microwave ablation combined with foam sclerotherapy in treatment of varicoseulcer of lower extremity.Methods A retrospective analysis was performed on the clinical data of 60 cases of patients with varicose ulcer of lower extremity admitted to First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2017 to January 2019.The patients were divided into 2 groups:treatment group(30 cases)and control group(30 cases).Patients in the treatment group underwent microwave ablation combined with polidocanol foam sclerotherapy on the basis of traditional Chinese medicine treatment,while those in the control group were given traditional Chinese medicine treatment.The follow-up time was 6 months.Results Six months after treatment,the wound healing rate of the treatment group(83.3%)was higher than that of the control group(46.7%)with statistically significant difference(P=0.003).The overall response rate of the treatment group(96.7%)was higher than that of the control group(83.3%),but there was no significant difference(P=0.197).The Kaplan-Meier survival analysis showed that the healing time of ulcer of the treatment group was shorter than that of the control group.The Venous Clinical Severity Score(VCSS)in the two groups was lower after 6 months of treatment,with statistically significant difference(t=21.850,t=10.582,all P<0.001)and the VCSS of patients in the treatment group was lower than that of the control group,with significant difference(t=-2.145,P=0.036).Conclusion Microwave ablation combined with foam sclerotherapy on the basis of traditional Chinese medicine treatment is safe and effective for the treatment of varicose ulcer of lower extremity,promoting ulcer healing and improving patients'postoperative VCSS.

关 键 词：下肢静脉曲张 溃疡 微波消融 聚多卡醇 泡沫硬化疗法 

分 类 号：R654.4[医药卫生—外科学]