泡沫硬化术联合激光闭合术治疗大隐静脉曲张的疗效观察  

Observation of the effect of foam sclerotherapy combined with laser closure in treating great saphenous vein varicosis

作　　者：史春雷 郭海涛[2] 姚雪峰 陈艳红 Shi Chunlei;Guo Haitao;Yao Xuefeng;Chen Yanhong(Department of Surgery,Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,Hebei,China;Department of Traditional Chinese Medicine,Handan City Hospital of Traditional Chinese Medicine,Handan 056000,Hebei,China)

机构地区：[1]承德市中医院外科,河北承德067000 [2]邯郸市中医院中医科,河北邯郸056000

出　　处：《血管与腔内血管外科杂志》2022年第5期596-600,630,共6页Journal of Vascular and Endovascular Surgery

基　　金：河北省中医药管理局科研计划项目(2019579)。

摘　　要：目的探讨泡沫硬化术联合激光闭合术治疗大隐静脉(GSV)曲张的疗效。方法收集2019年1月至2021年1月于承德市中医院接受手术治疗的90例GSV曲张患者的临床资料,根据治疗方式不同将患者分为激光组(采用单纯激光闭合术)和联合组(采用泡沫硬化术联合激光闭合术),每组45例。比较两组患者的手术指标(手术时间、住院时间、术中出血量),术前与术后1 d血清炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-D)]、血管内皮功能指标[循环内皮细胞(CEC)计数、内皮素-1(ET-1)、一氧化氮(NO)]水平。比较两组患者术后并发症发生情况及临床症状严重程度[静脉疾病临床严重程度评分表(VCSS)评分]。结果联合组患者的手术时间长于激光组患者,住院时间短于激光组患者(P<0.05)。术后1 d,联合组患者的IL-6、TNF-α、CRP水平均低于激光组患者,APTT、PT、TT均长于激光组患者,FIB、D-D水平均低于激光组患者(P<0.05)。术后1 d,联合组患者的CEC计数、ET-1水平均明显低于激光组患者,NO水平明显高于激光组患者(P<0.01)。联合组患者的术后并发症总发生率明显低于激光组患者(P<0.01)。术后2个月,联合组患者的VCSS评分明显低于联合组患者(P<0.01)。结论泡沫硬化术联合激光闭合术能够提高GSV曲张患者的临床疗效,减轻术后炎性反应,改善凝血功能和血管内皮细胞功能,降低术后并发症总发生率。Objective To investigate the efficacy of foam sclerotherapy combined with laser closure in the treatment of great saphenous vein(GSV)varicosis.Method The clinical data of 90 patients with GSV varicosis who underwent surgical treatment in Chengde Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were collected,and the patients were divided into laser group(using simple laser closure)and combined group(using foam sclerotherapy combined with laser closure)according to different treatment methods with 45 cases in each group.The operation indexes(operation time,hospital stay,intraoperative bleeding)of the two groups were compared.Before and 1 day after operation,the serum inflammatory factors[C reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-dimer(D-D)],vascular endothelial function indexes[circulating endothelial cell(CEC)count,endothelin-1(ET-1),nitric oxide(NO)]level were compared between the two groups.The incidence of postoperative complications and the severity of clinical symptoms[venous clinical severity score(VCSS)]were compared between the two groups.Result The operation time of the combined group was longer than that of the laser group,and the hospital stay was shorter than that of the laser group(P<0.05).One day after the operation,the levels of IL-6,TNF-α,and CRP in the combined group were lower than those in the laser group,APTT,PT and TT were longer than those in the laser group,and the levels of FIB and D-D were lower than those in the laser group(P<0.05).One day after the operation,the CEC count and ET-1 level of the combined group were significantly lower than those of the laser group,and the NO level was significantly higher than that of the laser group(P<0.01).The total incidence of postoperative complications in the combined group was significantly lower than that in the laser group(P<0.01).Two months after the op

关 键 词：大隐静脉曲张 泡沫硬化术 激光闭合术 炎性反应 凝血功能 

分 类 号：R543[医药卫生—心血管疾病]