超声引导下射频消融联合点式剥脱术及泡沫硬化剂对原发性小隐静脉曲张的治疗效果  

Effect of ultrasound-guided radiofrequency ablation combined with punctal stripping and foam sclerotherapy in the treatment of primary small saphenous varicose veins

作　　者：李井荣 荣智华 张望德[1] 李春民[1] Li Jingrong;Rong Zhihua;Zhang Wangde;Li Chunmin(Department of Vascular Surgery,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100069,China;Department of Vascular Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100032,China)

机构地区：[1]首都医科大学附属北京朝阳医院血管外科,北京100069 [2]中国医学科学院北京协和医学院北京协和医院血管外科,北京100032

出　　处：《血管与腔内血管外科杂志》2023年第6期641-644,653,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨超声引导下射频消融联合点式剥脱术及泡沫硬化剂治疗原发性小隐静脉曲张的临床疗效。方法收集2019年1月至2022年1月于首都医科大学附属北京朝阳医院与中国医学科学院北京协和医学院北京协和医院接受超声引导下射频消融联住点式剥脱术及泡沫硬化剂的24例小隐静脉曲张患者的临床资料,记录患者术后住院时间、下床活动时间、视觉模拟评分法(VAS)评分,统计患者术后并发症发生情况,所有患者均于术后2周、1个月、3个月行彩色多普勒超声随访,判断是否复发,使用静脉临床危重程度评分(VCSS)、阿伯丁静脉曲张问卷(AVVQ)、慢性静脉疾病生活质量量表(CIVIQ)评价治疗效果。结果24例患者平均手术时间为(50±24)min,平均射频消融时间为(2.31±0.12)min,平均射频功率为18 W,每个患者平均有2个点式剥脱切口,术后住院时间为(2.00±1.00)d,下床活动时间为(3.34±1.20)h,术后VAS评分为0~1分。术后2周、1个月、3个月进行彩色多普勒超声随访,90%(27/30)患肢治疗有效;术后3个月超声检查示小隐静脉几乎无血流,10%(3/30)患肢复发。术后,3例患肢血肿,4例淤血,1例皮下硬结,并发症总发生率为33.33%。术后1个月VCSS、AVVQ、CIVIQ评分均明显低于术前,差异均有统计学意义(P﹤0.01)。结论超声引导下射频消融联合点式剥脱术及泡沫硬化剂对原发性小隐静脉曲张的治疗效果显著,术后患者预后较好,具有较高的安全性。Objective To investigate the clinical efficacy of ultrasound-guided radiofrequency ablation combined with punctal stripping and foam sclerotherapy in the treatment of primary small saphenous varicose veins.Method The clinical data of 24 patients with small saphenous varicose veins who underwent ultrasound-guided radiofrequency ablation combined with punctal stripping and foam sclerotherapy in Beijing Chao-yang Hospital,Capital Medical University and Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College from January 2019 to January 2022 were collected.The postoperative hospital stay,out-of-bed time,and visual analog scale(VAS)scores were recorded.The incidence of postoperative complications of patients were counted.All patients were followed up by color Doppler ultrasonography at two weeks,one month,and three months after the operation to determine whether they were recurrence.The venous clinical severity score(VCSS),Aberdeen varicose vein questionnaire(AVVQ),and chronic venous insufficiency quality of life(CIVIQ)were used to evaluate the therapeutic effect.Result The average surgical time of 24 patients was(50±24)min,the average radiofrequency ablation time was(2.31±0.12)min,and the average radiofrequency power was 18 W.Each patient had average of 2 points stripping incisions.The postoperative hospitalization time was(2.00±1.00)d,and the time to get out of bed was(3.34±1.20)h.The postoperative VAS score was 0-2 points.Color Doppler ultrasound follow-up was conducted 2 weeks,1 month,and 3 months after surgery,90%(27/30)of the affected limbs were effectively treated;ultrasound examination at 3 months after surgery showed almost no blood flow in the small saphenous vein,and 10%(3/30)of the affected limbs recurred at 3 months after surgery.After surgery,there were 3 cases of limb hematoma,4 cases of congestion,and 1 case of subcutaneous sclerosis,the total incidence rate of complications was 33.33%.The VCSS,AVVQ,and CIVIQ scores at one month after surgery were sign

关 键 词：小隐静脉曲张 射频消融 超声 

分 类 号：R543[医药卫生—心血管疾病]