高位结扎联合泡沫硬化剂或点式剥脱治疗大隐静脉曲张的疗效对比分析  

Comparative analysis of high ligation and foam sclerotherapy or spot stripping in treatment of great saphenous varicose veins

作　　者：曾彦彰 袁平[1] 姜庆[1] 潘扬[1] ZENG Yanzhang;YUAN Ping;JIANG Qing;PAN Yang(Department of Vascular and Thyroid Surgery,Guizhou Provincial People’s Hospital,Guiyang 550002,P.R.China)

机构地区：[1]贵州省人民医院血管甲状腺外科,贵阳550002

出　　处：《中国普外基础与临床杂志》2023年第7期808-813,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：贵州省卫生健康委科学技术基金项目(项目编号:gzwkj2021-185);贵州省科技厅临床专项基金(黔科合成果-LC[2022]030)。

摘　　要：目的对比分析高位结扎联合点式剥脱(high ligation and spot stripping,HLSS)和高位结扎联合泡沫硬化剂治疗(high ligation and foam sclerotherapy,HLFS)治疗大隐静脉曲张(great saphenous varicose veins,GSVV)的效果。方法回顾性分析2018年1月至2022年6月期间于贵州省人民医院接受HLFS或HLSS治疗的385例GSVV患者的临床资料,对比2组患者的手术时间、术中出血量、并发症、术后住院时间等方面的差异。结果与HLSS组比较,HLFS组的手术时间更短(P<0.001),术中出血量更少(P<0.05),视觉模拟量表评分更低(P<0.001),术后住院时间更短(P<0.001),以及术后血肿发生率、皮肤感觉障碍发生率和感染发生率均更低(P值分别为<0.001、<0.001及0.011),但2组的复发率比较差异无统计学意义(χ^(2)=0.02,P=0.879)。HLFS组和HLSS组同组内与术前比较,术后第3个月时的改良静脉临床危重程度评分(venous clinical severity score,VCSS)降低、慢性静脉功能不全生活质量评分问卷(chronic lower limb venous insufficiency questionnaire,CIVIQ)评分升高,差异均有统计学意义(P<0.05);2组的VCSS和CIVIQ评分的改变值(术后3个月相比于术前的改变值)比较差异均无统计学意义(P>0.05)。结论HLFS治疗GSVV的疗效确切,且相较于HLSS创伤更小、恢复更快、术后并发症发生率更低,临床上可作为GSVV患者的手术方案选择。Objective To compare the effect of high ligation and spot stripping(HLSS)and high ligation and foam sclerotherapy(HLFS)in the treatment of great saphenous varicose veins(GSVV).Methods A retrospective analysis was conducted on the clinical data of 385 patients with GSVV who received HLFS or HLSS treatment at Guizhou Provincial People’s Hospital from January 2018 to June 2022.The differences in surgical time,intraoperative bleeding,complications,and postoperative hospital stay between the two groups were compared.Results The surgical time,intraoperative bleeding,postoperative hospital stay,visual analog scale for pain,incidence of postoperative hematoma,skin sensory disorders,and infection in the HLFS group were less or lower than those in the HLSS group(P<0.05),but there was no statistically significant difference in recurrence rate between the two groups(P>0.05).Compared with preoperative indicators at the same group,the modified venous clinical severity score(VCSS)decreased and the chronic lower limb venous insufficiency questionnaire(CIVIQ)score increased(P<0.05).However,there was no statistically significant difference in the degree of improvement in VCSS and CIVIQ between the two groups at three months after surgery and before surgery(P>0.05).Conclusions HLFS has a definite therapeutic effect on GSVV,with smaller trauma,faster recovery after surgery,and lower incidence of postoperative complication compared to HLSS.It can be used as a surgical option for GSVV patients in clinical practice.

关 键 词：大隐静脉曲张 高位结扎联合点式剥脱 高位结扎剥脱联合泡沫硬化治疗 疗效 

分 类 号：R654.4[医药卫生—外科学]