腔内激光术联合手术室优化配合措施对大隐静脉曲张患者手术疗效与主要症状的影响  

Effect of endovascular laser surgery combined with optimal cooperation measures in the operating room on the surgical efficacy and main symptoms of patients with great saphenous vein varicosis

作　　者：晁霞 贾伟[2] 赵丹[1] 冯缙 Chao Xia;Jia Wei;Zhao Dan;Feng Jin(Operating Room,Beijing Jishuitan Hospital,Beijing 100043,China;Department of Vascular Surgery,Beijing Jishuitan Hospital,Beijing 100043,China)

机构地区：[1]北京积水潭医院手术室,北京100043 [2]北京积水潭医院血管外科,北京100043

出　　处：《血管与腔内血管外科杂志》2022年第11期1331-1336,共6页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨腔内激光术联合手术室优化配合措施对大隐静脉(GSV)曲张患者手术疗效与主要症状的影响。方法收集2020年6月至2022年1月于北京积水潭医院接受腔内激光术治疗的110例GSV曲张患者的临床资料,将2020年6—12月采取常规手术室配合措施的患者作为常规组,将2021年1月至2022年1月采取手术室优化配合措施的患者作为优化组,每组55例。比较两组患者的术中、术后指标(手术时间、术中出血量、术后卧床时间、住院时间)。比较两组患者的术中配合度评分,麻醉前、术中10 min、术毕即刻的血流动力学指标(心率、平均动脉压),术前、术后1 d的炎性反应指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,术前、术后3 d的病情[静脉临床严重程度评分表(VCSS)评分]、睡眠质量[匹兹堡睡眠质量指数(PSQI)评分]、疼痛程度[视觉模拟评分法(VAS)评分]、患肢周径指标(患肢外踝、髌上10 cm、髌下10 cm处周径)。结果优化组患者的手术时间、术后卧床时间、住院时间均短于常规组患者,术中出血量少于常规组患者,配合度评分高于常规组患者,差异均有统计学意义(P<0.05)。术毕即刻,优化组患者的心率、平均动脉压均低于常规组患者,差异均有统计学意义(P<0.05)。术后1 d,优化组患者的CRP、IL-6、TNF-α水平均低于常规组患者,差异均有统计学意义(P<0.05)。术后3 d,优化组患者的VCSS、PSQI、VAS评分均低于常规组患者,患肢外踝、髌上10 cm、髌下10 cm处周径均小于常规组患者,差异均有统计学意义(P<0.05)。结论手术室优化配合措施能够缩短手术时间,降低术中出血量,提高手术疗效,促进患者术后恢复,进一步改善患者的术后症状,减轻术后疼痛程度,提高术后睡眠质量。Objective To investigate the effect of endovascular laser surgery combined with optimal cooperation measures in the operating room on the surgical efficacy and main symptoms of patients with great saphenous vein(GSV)varicosis.Method The clinical data of 110 patients with GSV varicosis who received endovascular laser surgery in Beijing Jishuitan Hospital from June 2020 to January 2022 were collected.Patients who took conventional operating room cooperation measures from June to December 2020 were taken as the conventional group.Patients who took optimal cooperation measures in the operating room from January 2021 to January 2022 were regarded as the optimization group.There were 55 cases in each group.The intraoperative and postoperative indicators(operation time,intraoperative blood loss,postoperative bed rest time,and hospital stay)of the two groups were compared.The intraoperative cooperation degree score,the hemodynamic indexes(heart rate,mean arterial pressure)before anesthesia,10 minutes during the operation,and immediately after the operation,the inflammatory response indexes[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels before and one day after the operation,and the disease condition[venous clinical severity score(VCSS)],the sleep quality[Pittsburgh sleep quality index(PSQI)score],the pain level[visual analogue scale(VAS)score],the circumference indexes of the affected limb(circumference of the lateral malleolus,suprapatellar 10 cm,and subpatellar 10 cm of the affected limb)before and three days after the operation between the two groups were compared.Result The operation time,postoperative bed rest time,and hospital stay of patients in the optimization group were shorter than those in the conventional group,the intraoperative blood loss was lower than that of patients in the conventional group,and the intraoperative cooperation degree score was higher than that of patients in the conventional group,and the differences were statistically significant(P<0.05).Immediately

关 键 词：大隐静脉曲张 腔内激光术 优化配合 手术室 手术疗效 症状 

分 类 号：R543[医药卫生—心血管疾病]