腔内激光消融术治疗下肢慢性静脉功能不全的临床疗效及术后相关指标的分析  

Efficacy and postoperative indexes of endovenous laser surgery for chronic venous insufficiency of lower extremity

作　　者：吴崇才 吴清强 刘琪 Wu Chongcai;Wu Qingqiang;Liu Qi(Department of General Surgery,the Fourth People's Hospital of Haikou,Haikou 571100,Hainan,China;Department of General Medicine,the Fourth People's Hospital of Haikou,Haikou 571100,Hainan,China)

机构地区：[1]海口市第四人民医院普通外科,海南海口571100 [2]海口市第四人民医院全科医学科,海南海口571100

出　　处：《血管与腔内血管外科杂志》2022年第10期1221-1225,共5页Journal of Vascular and Endovascular Surgery

基　　金：海南省自然科学基金(819MS144)。

摘　　要：目的探讨腔内激光消融术(EVLS)治疗下肢慢性静脉功能不全(CVI)的临床疗效及术后相关指标。方法收集2019年1月至2021年6月于海口市第四人民医院接受EVLS治疗的78例CVI患者的临床资料,根据治疗方法的不同将其分为传统组和激光组,每组39例。传统组采用传统静脉剥脱术治疗,激光组采用EVLS治疗。比较两组患者临床相关指标,观察两组患者术前及术后7 d的病情程度、睡眠质量、疼痛程度、患肢周径变化情况。出院前统计两组患者术后并发症发生情况,术后1个月观察两组患者生活质量变化情况,术后6个月统计两组患者的复发情况。结果激光组患者手术时间、切口长度、首次下床活动时间、住院时间均短于传统组患者,术中出血量低于传统组患者,差异均有统计学意义(P<0.05)。术后7 d,两组患者静脉临床严重程度评分(VCSS)、匹兹堡睡眠质量指数(PSQI)评分均低于本组术前,且激光组患者VCSS、PSQI评分均低于传统组患者,差异均有统计学意义(P<0.05)。术后7 d,两组患者视觉模拟评分量表(VAS)评分、外踝周径、髌上10 cm处周径、髌下10 cm处周径均低于本组术前,且激光组患者上述指标均低于传统组患者,差异均有统计学意义(P<0.05)。术后1个月,两组患者慢性静脉功能不全问卷-20(CIVIQ-20)各维度评分、总分均高于本组术前,且激光组患者上述指标均高于传统组患者,差异均有统计学意义(P<0.05)。激光组患者术后并发症总发生率为7.69%(3/39),低于传统组患者的28.21%(11/39),差异有统计学意义(P<0.05)。两组患者术后复发率比较,差异无统计学意义(P>0.05)。结论EVLS治疗下肢慢性静脉功能不全患者的疗效较好,具有手术创伤小、术中出血量低、术后恢复快等优势,能够降低患者术后并发症的发生风险,提高患者的术后生活质量,且不增加患者术后的复发风险,值得临床推广应用。Objective To investigate the efficacy and postoperative indexes of endovenous laser surgery(EVLS)in the treatment of chronic venous insufficiency(CVI)of lower extremity.Method The data of 78 CVI patients treated with EVLS in the Fourth People's Hospital of Haikou from January 2019 to June 2021 were collected.The patients were divided into traditional group(n=39,received traditional venotomy)and laser group(n=39,received EVLS).The clinical related indexes of two groups were compared.The degree of illness,sleep quality,pain degree,change of perimeter of the involved extremity of two groups before and 7 days after surgery were observed.Before discharge,the incidence of postoperative complications of two groups were counted.One month after surgery,the quality of life of two groups was observed.Six months after surgery,the recurrence of two groups was counted.Result The operative time,incision length,ambulation time,hospital stay and intraoperative blood loss in the laser group were lower than those in the traditional group,the differences were statistically significant(P<0.05).Seven days after surgery,the venous clinical severity score(VCSS)and Pittsburgh sleep quality index(PSQI)of two groups were lower than those before surgery,the scores of VCSS and PSQI in laser group were lower than those in traditional group,the differences were statistically significant(P<0.05).Seven days after surgery,the scores of visual analogue scale(VAS),malleolus perimeter,perimeter at 10 cm above the iliac and perimeter at 10 cm below the iliac in two groups were all lower than those before surgery,the above indexes of patients in laser group were lower than those in traditional group,the differences were statistically significant(P<0.05).One month after surgery,dimensional and total scores of chronic venous insufficiency questionnaire-20(CIVIQ-20)in two groups were higher than those before surgery,the above scores of patients in laser group were higher than those in traditional group,the differences were statistically significant(P<0.0

关 键 词：下肢慢性静脉功能不全 腔内激光消融术 临床疗效 术后恢复进程 

分 类 号：R543[医药卫生—心血管疾病]