腔内激光消融术治疗原发性大隐静脉曲张的手术效果、安全性及术后康复质量分析  

Analysis of the surgical effect,surgical safety and postoperative rehabilitation quality of endovascular laser ablation for primary great saphenous varicose veins

作　　者：王为华 WANG Wei-hua(Department of Vascular Surgery,Juye People's Hospital,Heze 274900,China)

机构地区：[1]山东省巨野县人民医院血管外科,274900

出　　处：《中国现代药物应用》2023年第9期27-31,共5页Chinese Journal of Modern Drug Application

摘　　要：目的分析原发性大隐静脉曲张行腔内激光消融术治疗的手术效果、手术安全性及术后康复质量。方法73例原发性大隐静脉曲张患者,采用中心随机系统分组法分为对照组(37例)和研究组(36例)。对照组患者行大隐静脉高位结扎术治疗,研究组患者行腔内激光消融术治疗。比较两组患者治疗有效率、大隐静脉闭合率、静脉曲张复发率,静脉曲张残留指标,术后疼痛评分、疼痛持续时间、恢复时间,手术并发症发生率,手术前后患肢血流速度、静脉临床严重程度评分表(VCSS)评分。结果两组患者治疗有效率、大隐静脉闭合率比较差异无统计学意义(P>0.05);研究组患者术后6个月内静脉曲张复发率为2.78%,低于对照组的21.62%,差异具有统计学意义(P<0.05)。两组患者术后残留静脉曲张血管数量比较差异无统计学意义(P>0.05);研究组患者残留静脉曲张血管直径(1.55±0.21)mm、残留静脉曲张血管长度(3.64±1.24)cm均短于对照组的(2.34±0.32)mm、(4.75±2.45)cm,差异具有统计学意义(P<0.05)。研究组患者术后视觉模拟评分法(VAS)评分(2.16±0.94)分低于对照组的(3.65±1.34)分,术后疼痛持续时间(1.05±0.34)d、术后恢复时间(3.02±1.41)d短于对照组的(3.75±1.48)、(7.21±2.37)d,差异具有统计学意义(P<0.05)。两组患者手术并发症发生率比较差异无统计学意义(P>0.05)。术后第7天,研究组患者患肢髂外静脉血流速度(25.14±1.86)cm/s、股静脉血流速度(26.87±1.57)cm/s、腘静脉血流速度(18.25±1.22)cm/s高于对照组的(24.25±1.73)、(25.11±1.08)、(15.92±0.93)cm/s,差异具有统计学意义(P<0.05);术后1个月,研究组患者VSCC评分(3.17±0.87)分低于对照组的(4.45±1.56)分,差异具有统计学意义(P<0.05)。结论腔内激光消融术对原发性大隐静脉曲张的治疗效果与传统高位结扎术相当,但腔内激光消融术治疗中局部麻醉、泡沫硬化剂填充技术的配合均可有效提升Objective To analyze the surgical effect,surgical safety and postoperative rehabilitation quality of endovascular laser ablation for primary great saphenous varicose veins.Methods A total of 73 patients with primary great saphenous varices veins were divided into control group(37 cases)and research group(36 cases)by central randomized system grouping method.The control group received high ligation of the great saphenous vein,and the research group received endovascular laser ablation.Both groups were compared in terms of treatment efficiency,occlusion rate of saphenous vein,recurrence rate of varicose veins,varicose vein residual index,postoperative pain score,pain duration,recovery time,incidence of surgical complications,blood flow velocity of the affected limb before and after surgery,and venous clinical severity score(VCSS).Results There was no statistically significant differences in treatment efficiency and occlusion rate of saphenous vein between the two groups(P>0.05).The recurrence rate of varicose veins was 2.78% in the research group within 6 months after surgery,which was lower than that of 21.62% in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the number of postoperative residual varicose vessels between the two groups(P>0.05).The diameter of residual varicose vessels of(1.55±0.21)mm and the length of residual varicose vessels of(3.64±1.24)cm in the research group were shorter than those of(2.34±0.32)mm and(4.75±2.45)cm in the control group,and the differences were statistically significant(P<0.05).The VAS score of(2.16±0.94)points in the research group was lower than that of(3.65±1.34)points in the control group;the postoperative pain duration of(1.05±0.34)d and postoperative recovery time of(3.02±1.41)d in the research group were shorter than those of(3.75±1.48)and(7.21±2.37)d in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the

关 键 词：腔内激光消融术 原发性大隐静脉曲张 高位结扎术 临床效果 

分 类 号：R654.4[医药卫生—外科学]