X线透视导引下经皮大隐静脉高位缝扎结合泡沫硬化治疗原发性大隐静脉曲张113例效果分析  

Fluoroscopy-guided percutaneous high ligation of great saphenous vein combined with foam sclerotherapy for primary great saphenous varicose:analysis of its clinical efficacy in 113 patients

作　　者：刘正立 何旭[1] 顾建平[1] 付冠琦 公茂峰 赵伯翔[1] 孔杰 LIU Zhengli;HE Xu;GU Jianping;FU Guanqi;GONG Maofeng;ZHAO Boxiang;KONG Jie(Department of Interventional Radiology,Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing Municipal First Hospital,Nanjing,Jiangsu Province 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)介入血管科,210006

出　　处：《介入放射学杂志》2022年第5期455-458,共4页Journal of Interventional Radiology

基　　金：国家自然科学基金(81871463);南京医科大学科技发展基金(NMUB2019158)。

摘　　要：目的评价X线透视导引下经皮高位缝扎结合泡沫硬化治疗原发性大隐静脉(GSV)曲张的有效性和安全性。方法回顾性分析2019年4月1日至10月31日在南京医科大学附属南京医院接受X线透视导引下经皮GSV高位缝扎结合泡沫硬化术治疗的113例(133条肢体)原发性GSV曲张患者临床资料。其中男60例,女53例,年龄为(62.1±10.8)岁。透视导引下高位缝扎GSV近端,同时行泡沫硬化治疗。术后1、3、6、12个月随访,超声评估GSV闭塞率及相关并发症发生率,术后12个月复查评估静脉疾病临床严重度评分(VCSS),并与术前VCSS比较。结果133条患肢手术均获成功。共112条患肢(84.07%)获12个月随访,103条患肢(91.96%)GSV维持闭塞;VCSS由术前4.71±2.15改善至0.74±0.60(V=6328,P<0.01);16条患肢出现血栓性静脉炎,38条患肢出现缝扎处疼痛,均在2周内自行缓解;所有患者均未出现下肢深静脉血栓形成,无严重并发症发生。结论X线透视导引下经皮高位缝扎结合泡沫硬化治疗GSV曲张操作简单、安全有效,GSV闭塞率与静脉热消融相似。Objective To evaluate the efficacy and safety of fluoroscopy-guided percutaneous high ligation(FG-PHL)of great saphenous vein combined with fluoroscopy-guided foam sclerotherapy(FG-FS)in the treatment of primary great saphenous varicose(GSV).Methods The clinical data of 113 patients with primary GSV(133 diseased limbs in total),who were admitted to the Affiliated Nanjing Hospital of Nanjing Medical University of China to receive FG-PHL of great saphenous vein combined with FG-FS between April 1,2019 and October 31,2019,were retrospectively analyzed.The patients included 60 males and 53 females with a mean age of(62.1±10.8)years.Under fluoroscopy guidance,ligation of proximal end of GSV was performed,and at the same time foam sclerotherapy was carried out.Postoperative one-,3-,6-,and 12-month follow-up check was conducted,the occlusion rate of GSV and procedure-related complications were assessed by ultrasonography.Twelve months after treatment,reexamination was performed to evaluate venous clinical severity score(VCSS),and the results were compared with preoperative values.Results FG-PHL plus FG-FS were successfully accomplished for all the 133 diseased limbs.A total of 112 limbs(84.2%)were followed up,which showed that GSV remained occluded in 103 diseased limbs(92.0%).VCSS decreased from preoperative(4.71±2.15)points to postoperative(0.74±0.60)points(V=6328,P<0.001).Sixteen diseased limbs developed thrombophlebitis,and pain at the suture ligation site occurred in 38 diseased limbs,which were spontaneously alleviated within 2 weeks.No deep venous thrombosis in the lower limbs or other severe complications occurred in all patients.Conclusion For the treatment of GSV,FG-PHL combined with FG-FS is clinically safe,effective and technically-simple,and its occlusion rate of GSV is similar to that of intravenous thermal ablation.

关 键 词：X线透视导引 经皮高位缝扎术 大隐静脉曲张 泡沫硬化疗法 

分 类 号：R654[医药卫生—外科学]