腔内射频消融术与激光消融术治疗下肢静脉曲张的疗效及安全性分析  

Efficacy and safety of endovenous radiofrequency ablation versus laser ablation in treatment of lower extremity varicose vein

作　　者：周煜明 杨涛[1] 郝斌[1] Zhou Yuming;Yang Tao;Hao Bin(Department of Vascular Surgery,Third Hospital of Shanxi Medical University(Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital),Taiyuan 030032,Shanxi,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院山西医学科学院同济山西医院)血管外科,山西太原030032

出　　处：《血管与腔内血管外科杂志》2023年第3期281-286,共6页Journal of Vascular and Endovascular Surgery

基　　金：山西省重点研发计划项目(201803D31147)。

摘　　要：目的探讨腔内射频消融术(RFA)和激光消融术(EVLA)治疗下肢静脉曲张的疗效和安全性。方法收集2020年12月至2021年11月山西医科大学第三医院(山西白求恩医院山西医学科学院同济山西医院)收治的120例(149条肢体)下肢静脉曲张患者的临床资料,根据手术方式的不同将其分为RFA组68例患者(87条肢体)和EVLA组52例患者(62条肢体)。比较两组患者大隐静脉闭合率、手术相关指标,记录两组患者手术前后的静脉再充盈时间(VRT)、静脉临床严重程度评分(VCSS)、慢性静脉功能不全问卷(CIVIQ-14)评分。结果RFA组患者术中出血量低于EVLA组患者,住院时间短于EVLA组患者,差异均有统计学意义(P<0.05);两组患者手术时间、术后并发症发生情况比较,差异均无统计学意义(P>0.05)。术后1、3个月,两组患者大隐静脉闭合率比较,差异均无统计学意义(P>0.05)。手术前后两组患者VCSS、CIVIQ-14评分比较,差异均无统计学意义(P>0.05);术后1个月,两组患者的VCSS均低于本组术前,CIVIQ-14评分均高于本组术前;术后3个月,两组患者的VCSS均低于本组术后1个月,CIVIQ-14评分均高于本组术后1个月,差异均有统计学意义(P<0.05)。手术前后两组患者VRT、VRT(膝上加压)比较,差异均无统计学意义(P>0.05)。术后1、3个月,两组患者VRT、VRT(膝上加压)均长于本组术前,差异均有统计学意义(P<0.05)。结论术后1、3个月,RFA、EVLA治疗下肢静脉曲张临床疗效明显,可明显改善患者的下肢静脉反流情况,且RFA手术具有术中出血量少、住院时间短、并发症发生率低等优点。Objective To explore the efficacy and safety of endovenous radiofrequency ablation(RFA)and endovenous laser ablation(EVLA)in the treatment of lower extremity varicose vein.Method A total of 120 patients(149 limbs)with lower extremity varicose veins who were treated in Third Hospital of Shanxi Medical University(Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital)from December 2020 to November 2021 were selected.According to the surgery methods,there were were divided into 68 patients(87 limbs)in the RFA group and 52 patients(62 limbs)in the EVLA group.Closure rate of the great saphenous vein,surgical related indexes of two groups were compared,venous refill time(VRT),venous clinical severity score(VCSS)and scores of chronic venous insufficiency questionnaire(CIVIQ-14)of two groups were recorded.Result The intraoperative blood loss and time of hospital stay in RFA were lower than those in the EVLA group,the differences were statistically significant(P<0.05).There were no significant differences for the surgery time and postoperative complications(P>0.05).There was no significant difference for the closure rate of the great saphenous vein 1 and 3 months after surgery in two groups(P>0.05).There were no significant difference for the scores of VCSS and CIVIQ-14 in two groups before and after surgery(P>0.05);1 month after surgery,the VCSS of both groups were lower than that of this group before surgery,and the CIVIQ-14 scores of both groups were higher than that of this group before surgery;3 months after surgery,the VCSS of both groups were lower than that of this group one month after surgery,and the CIVIQ-14 scores of both groups were higher than that of this group one month after surgery,the differences were statistically significant(P<0.05).There was no significant difference for the VRT and VRT(pressing above the knees)before and after surgery(P>0.05);the VRT and VRT(pressing above the knees)in both groups 1 and 3 months after surgery were longer than those before surgery,the diffe

关 键 词：下肢静脉曲张 射频消融术 激光消融术 静脉再充盈时间 双功能超声 

分 类 号：R543[医药卫生—心血管疾病]