SEPS联合HSL对大隐静脉曲张性溃疡患者VCSS评分及远期疗效的影响  

Effect of SEPS combined with HSL on VCSS score and long-term curative effect of patients with varicose ulcer of great saphenous vein

作　　者：张爱军 严姣华 熊雄 ZHANG Ai-jun;YAN Jiao-hua;XIONG Xiong(Department of General Surgery,Wuchang Hospital Affiliated to Wuhan University of Science and Technology(Wuhan Wuchang Hospital),Wuhan Hubei 430063,China;Department of Nursing,Wuchang Hospital Affiliated to Wuhan University of Science and Technology(Wuhan Wuchang Hospital),Wuhan Hubei 430063,China)

机构地区：[1]武汉科技大学附属武昌医院(武汉市武昌医院)普外科,湖北武汉430063 [2]武汉科技大学附属武昌医院(武汉市武昌医院)护理部,湖北武汉430063

出　　处：《临床和实验医学杂志》2021年第24期2621-2624,共4页Journal of Clinical and Experimental Medicine

基　　金：武汉市卫计委科研项目(编号:WX15C18);2018年度湖北省卫生健康委联合基金项目(编号:WJ2018H0099)。

摘　　要：目的探讨腔镜深筋膜下交通支离断术(SEPS)联合传统大隐静脉高位结扎剥脱术(HSL)对大隐静脉曲张性溃疡患者静脉临床严重程度评分(VCSS)评分及远期疗效的影响。方法回顾性选取2016年1月至2020年1月武汉科技大学附属武昌医院收治的大隐静脉曲张性溃疡患者94例作为研究对象,依据治疗方法分为观察组47例与对照组47例。观察组患者采用SEPS联合HSL治疗,对照组患者单纯采用HSL治疗。所有患者均为完成12个月随访。比较两组手术指标(包括术中出血量、手术时间、下床活动时间和住院时间)变化和术后并发症情况;术前、术后6个月和术后12个月VCSS评分变化;及术后12个月复发情况。结果观察组患者术中出血量为(26.84±6.51)m L,少于对照组[(57.39±9.83)m L],手术时间为(78.83±13.24)min,长于对照组[(54.23±10.92)min],下床活动时间和住院时间(20.74±3.24)、(6.52±1.48)h,短于对照组[(28.93±2.65)、(9.95±1.79)h],差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率(8.51%)低于对照组27.66%,差异有统计学意义(P<0.05)。两组患者术后6个月和术后12个月VCSS评分低于术前,差异均有统计学意义(P<0.05);观察组患者术后6个月和术后12个月VCSS评分为(3.03±0.56)、(1.89±0.45)分,低于对照组[(4.51±0.87)、(3.26±0.71)分],差异均有统计学意义(P<0.05)。观察组术后12个月复发率(2.13%)低于对照组(17.02%),差异有统计学意义(P<0.05)。结论SEPS联合HSL治疗对大隐静脉曲张性溃疡患者远期疗效良好,术中出血量少,可加快患者快速康复,缩短住院时间,降低术后并发症,减轻患者病情,且复发率低,值得临床推广应用。Objective To investigate the venous clinical severity score(VCSS)score and long-term effect of subfascial endoscopic perforator surgery(SEPS)combined with traditional great saphenous vein high ligation and stripping(HSL)in patients with varicose ulcer of great saphenous vein impact.Methods A total of 94 patients with varicose ulcer of the saphenous vein were retrospectively selected from Wuchang Hospital Affiliated to Wuhan University of Science and Technology from January 2016 to January 2020.According to the treatment method,they were divided into an observation group of 47 cases and a control group of 47 cases.Patients in the observation group were treated with SEPS combined with HSL,and patients in the control group were treated with HSL alone.All patients completed a 12-month follow-up.The changes in surgical indicators(including intraoperative blood loss,operation time,time to get out of bed and length of hospital stay)and postoperative complications were compared between the two groups;the changes in VCSS scores before,6 months and 12 months after surgery;and recurrence at 12 months after surgery.Results The intraoperative blood loss of the observation group was(26.84±6.51)mL,which was less than that of the control group[(57.39±9.83)mL],and the operation time was(78.83±13.24)min,which was longer than that of the control group[(54.23±10.92)min],the saphenous vein took time out of bed and hospital stay was(20.74±3.24),(6.52±1.48)h,which was shorter than that of the control group[(28.93±2.65),(9.95±1.79)h],the differences werestatistically significant(P<0.05).The incidence of postoperative complications in the observation group(8.51%)was lower than 27.66%in the control group,and the difference was statistically significant(P<0.05).The VCSS scores of the two groups of patients at 6 months and 12 months after surgery were lower than those before the operation,and the differences were statistically significant(P<0.05);the VCSS scores of the patients in the observation group at 6 months and 12 months afte

关 键 词：大隐静脉曲张性溃疡 腔镜深筋膜下交通支离断术 传统大隐静脉高位结扎剥脱术 静脉临床严重程度 远期疗效 

分 类 号：R654.4[医药卫生—外科学]