腔内激光治疗与改良大隐静脉高位结扎剥脱术治疗下肢静脉曲张的临床研究  

Clinical study of endovenous laser therapy and modified great saphenous vein high ligation and stripping in the treatment of lower extremity varicose vein

作　　者：聂宗杰 方灿军 邱海军 潘力生[1] Nie Zongjie;Fang Canjun;Qiu Haijun;Pan Lisheng(Department of Vascular Surgery,Anqing Municipal Hospital,Anqing 246003,Anhui,China)

机构地区：[1]安庆市立医院血管外科,安徽安庆246003

出　　处：《血管与腔内血管外科杂志》2022年第10期1226-1229,1240,共5页Journal of Vascular and Endovascular Surgery

基　　金：安徽医科大学2019年度校科研基金(2019xkj111)。

摘　　要：目的探究腔内激光治疗(EVLT)与改良大隐静脉高位结扎剥脱术治疗下肢静脉曲张的临床疗效。方法收集2019年4月至2022年1月安庆市立医院收治的80例下肢静脉曲张患者的临床资料,根据治疗方式的不同将患者分为EVLT组(n=39,采用EVLT治疗)与改良组(n=41,采用改良大隐静脉高位结扎剥脱术治疗)。比较两组患者的手术相关指标(住院时间、术中出血量、手术时间),术前、术后3 d应激反应指标[血清皮质醇(Cor)、C反应蛋白(CRP)]水平。比较两组患者术前、术后1个月的疼痛程度[视觉模拟评分法(VAS)评分]、静脉曲张严重程度[静脉临床严重程度评分(VCSS)]。比较两组患者术后至出院期间并发症发生情况。结果EVLT组患者的住院时间、手术时间均明显短于改良组患者,术中出血量明显低于改良组患者,差异均有统计学意义(P<0.01)。术后3 d,EVLT组患者的Cor、CRP水平均低于改良组患者,差异均有统计学意义(P<0.05)。术后1个月,EVLT组患者的VAS评分、VCSS均低于改良组患者,差异均有统计学意义(P<0.05)。术后至出院期间,两组患者发热、静脉炎的发生率比较,差异均无统计学意义(P>0.05)。EVLT组患者隐神经损伤、皮下血肿的发生率均低于改良组患者,差异均有统计学意义(P<0.05)。结论与改良大隐静脉高位结扎剥脱术相比,EVLT治疗下肢静脉曲张的手术时间更短,患者疼痛程度更轻,有利于患者术后恢复。Objective To investigate the clinical efficacy of endovenous laser treatment(EVLT)and modified great saphenous vein high ligation and stripping in the treatment of lower extremity varicose vein.Method The clinical data of 80 patients with lower extremity varicose vein admitted to Anqing Municipal Hospital from April 2019 to January 2022 were collected.The patients were divided into the EVLT group(n=39,treated with EVLT)and the modified group(n=41,treated with modified great saphenous vein high ligation and stripping)according to different treatment methods.The surgery-related indexes(hospitalization time,intraoperative blood loss,operation time),and the levels of stress response indexes[serum cortisol(Cor)and C-reactive protein(CRP)]before the surgery and 3 days after the surgery were compared between the two groups.The pain level[visual analogue scale(VAS)score],and the severity of varicose vein[venous clinical severity score(VCSS)]before surgery and 1 month after surgery were also compared between the two groups.The incidence of complications in the two groups from postoperative to hospital discharge was also compared.Result The hospitalization time and operation time of the EVLT group were significantly shorter than those of the modified group,and the intraoperative blood loss was significantly lower than that of the modified group,and the differences were statistically significant(P<0.01).Three days after the surgery,the levels of Cor and CRP in the EVLT group were lower than those in the modified group,and the differences were statistically significant(P<0.05).One month after the surgery,the VAS score and VCSS of the EVLT group were lower than those in the modified group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence rate of fever and phlebitis between the two groups from postoperative to discharge(P>0.05).The incidence rate of saphenous nerve injury and subcutaneous hematoma in the EVLT group were lower than those in the modified group,and the

关 键 词：静脉曲张 激光疗法 高位结扎剥脱术 临床疗效 并发症 

分 类 号：R543[医药卫生—心血管疾病]