不同浓度泡沫硬化剂联合主干腔内激光消融一期闭合属支曲张静脉的疗效及安全性观察  

Observation of effect and safety of sclerosing foams prepared by different concentrations of polidocanol on treating tributary varicose veins with first-phase endovenous laser ablation on the trunk

作　　者：薛栋 张姝靓 冯玥琦 李延 冯骏[1] 禄韶英[1] 王吉昌[1] Xue Dong;Zhang Shuliang;Feng Yueqi;Li Yan;Feng Jun;Lu Shaoying;Wang Jichang(Department of Vascular Surgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710067,China)

机构地区：[1]西安交通大学第一附属医院血管外科,西安710067

出　　处：《中国血管外科杂志（电子版）》2021年第4期319-322,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金面上项目(81972811);陕西省青年科技新星项目(S2021-0-ZC-XXXM-0048)。

摘　　要：目的比较1%和3%聚多卡醇所制备的泡沫硬化剂(foam sclerotherapy,FS)联合大隐静脉主干腔内激光消融(endovenous laser ablation,EVLA)同期闭合属支曲张静脉的安全性及临床疗效。方法回顾性分析2017年1月至2018年6月西安交通大学第一附属医院大隐静脉主干EVLA同期联合属支曲张静脉FS治疗的273例患者资料,其中117例接受1%聚多卡醇配置的FS(1%FS组)治疗,156例接受3%FS治疗(3%FS组)。比较两组患者曲张静脉残留、静脉临床严重程度评分(venous clinical severity score,VCSS)、术后并发症等指标。结果3%FS组的曲张静脉残留数量与1%FS组差异无统计学意义(P>0.05)。两组患者术后均未发生深静脉血栓形成或肺栓塞。3%FS组的局部硬结发生率在术后1、6个月均显著高于1%FS组;3%FS组浅静脉炎发生率和VCSS在术后1个月时高于1%FS组,但在术后6个月时差异则无统计学意义;两组的术后切口感染率、皮下淤血发生率和感觉异常发生率差异无统计学意义。结论在EVLA闭合曲张静脉主干的同期,1%聚多卡醇制备的FS治疗属支曲张静脉的作用不劣于3%聚多卡醇FS,且早期并发症发生率更低,生活质量改善更快。Objective Comparison of the safety and clinical efficacy of foam sclerotherapy(FS)prepared with 1% and 3% polidocanol combined with endovenous laser ablation(EVLA)in the closure of varicose veins at the same time.Methods The clinical data of 273 patients treated with EVLA on the trunk of great saphenous vein and FS on tributary varicose veins in the First Affiliated Hospital of Xi’an Jiaotong University from January 2017 to June 2018 were analyzed retrospectively.Among them,117 patients received FS prepared with 1% polidocanol(1%FS group)and 156 patients received FS prepared with 3% polidocanol(3%FS group).The residual varicose veins,venous clinical severity score(VCSS),postoperative complications were compared between the two groups.Results The number of residual varicose veins in the 3%FS group was not statistically different from that in the 1%FS group(P>0.05).No deep venous thrombosis or pulmonary embolism occurred in either group.The incidence of local induration in the 3%FS group was significantly higher than that in the 1%FS group at 1 and 6 months after surgery.The incidence of superficial phlebitis and VCSS in the 3%FS group was higher than that in the 1%FS group at 1 month after surgery.However,the difference was not statistically significant at 6 months after surgery.There was no statistically significant difference in the incidence of postoperative incision infection,subcutaneous congestion,and paresthesia between the two groups.Conclusion With concomitant EVLA on the trunk of great saphenous vein,FS prepared by 1% polidocanol is not inferior to 3% polidocanol in the treatment of varicose veins,and its early complications are lower and the quality of life improves faster.

关 键 词：静脉曲张 泡沫硬化剂 腔内激光消融 微创治疗 

分 类 号：R543.6[医药卫生—心血管疾病]