超声引导下射频消融联合泡沫硬化剂治疗不同管径大隐静脉曲张的临床价值  

Clinical value of ultrasound-guided radiofrequency ablation combined with foam sclerosing agent in the treatment of varicose great saphenous vein with different diameters

作　　者：曾欣 周洋[1] 叶鸣[1] 王弼偲[2] 陈芮 汤雪瑶 周鸿[1] ZENG Xin;ZHOU Yang;YE Ming;WANG Bisi;CHEN Rui;TANG Xueyao;ZHOU Hong(Department of Ultrasound,the Third People’s Hospital of Chengdu,Chengdu 610000,China)

机构地区：[1]成都市第三人民医院超声科,610000 [2]成都市第三人民医院介入血管中心,610000

出　　处：《临床超声医学杂志》2023年第10期839-843,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 探讨超声引导下射频消融联合泡沫硬化剂治疗不同管径大隐静脉曲张及超声在术后短期疗效评估中的临床价值。方法 选取我院收治的大隐静脉曲张患者145例(145条患肢),根据术前超声测量大隐静脉大腿段最大管径分为A组(管径<10 mm)98例和B组(管径≥10 mm)47例,两组均采用超声引导下腔内射频消融闭合大隐静脉主干和注射泡沫硬化剂治疗小腿曲张浅静脉。比较两组消融次数和术后即刻、1个月、6个月大隐静脉闭塞率、残留管径、汇入口残留长度,以及术后并发症发生情况。结果 B组每节段平均消融次数大于A组,差异有统计学意义(P<0.05)。A组、B组术后即刻大隐静脉闭塞率均为100%,术后1个月分别为97.96%、100%,术后6个月分别为95.92%、95.74%,两组各时间点大隐静脉闭塞率比较差异均无统计学意义。术后1个月、6个月B组大隐静脉残留管径均大于A组,差异均有统计学意义(均P<0.05)。两组患者术后均未出现深静脉血栓、肺栓塞等严重并发症,出现皮下瘀斑和皮肤灼伤占比比较差异均无统计学意义;B组出现皮下条索僵硬静脉占比大于A组,差异有统计学意义(P<0.05)。结论 超声引导下射频消融联合泡沫硬化剂治疗不同管径大隐静脉曲张后短期内大隐静脉闭塞率较高,但较大管径的大隐静脉可能需要更多的消融周期;超声在术中引导及监测、术后随访和疗效评估中均有重要的临床价值。Objective To explore the clinical value of ultrasound-guided radiofrequency ablation combined with foam sclerosing agent in the treatment of varicose great saphenous vein with different diameters and ultrasound in the short-term efficacy evaluation after operation.Methods A total of 145 patients(145 affected limbs)with varicose great saphenous vein in our hospital were selected and divided into group A(diameter<10 mm,n=98)and group B(diameter≥10 mm,n=47)according to the preoperative ultrasound measurement of the maximum diameter of the thigh segment of the great saphenous vein.Both groups were treated by ultrasound-guided intracavitary radiofrequency ablation to close the trunk of the great saphenous vein and injection of foam sclerosing agent to treat superficial varicose veins of the lower leg.The ablation times,the occlusion rate of great saphenous vein immediately,1 month,and 6 months after surgery,the residual lumen diameter and length,the postoperative complications were compared between the two groups.Results The average ablation time of each segment in group B was higher than that in group A,and the difference was statistically significant(P<0.05).The immediate occlusion rates of the great saphenous vein in group A and group B were 100%,and the occlusion rates of the great saphenous vein 1 month after surgery were 97.96%and 100%,6 months after surgery were 95.92%and 95.74%,respectively.There were significant difference in the occlusion rate of great saphenous vein between the two groups(both P<0.05).The residual diameter of great saphenous vein in group B was larger than that in group A at 1 month and 6 months after surgery,and the differences were statistically significant(both P<0.05).There were no severe complications such as deep vein thrombosis and pulmonary embolism occurred in the two groups after surgery,and there were no significant difference in the proportion of subcutaneous ecchymosis and skin burns between the two groups.The proportion of subcutaneous cord stiffness veins in group B was hig

关 键 词：超声引导 射频消融 大隐静脉曲张 管径 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]