日间手术模式下不同方法治疗大隐静脉曲张的临床疗效  

Clinical efficacy of different methods in treatment of great saphenous varicose veins under daytime surgery mode

作　　者：许磊 林晨[1,2,3] Xu Lei;Lin Chen(Clinical Medical College,Fuzhou General Hospital,Fujian Medical University,Fuzhou 350001,Fujian,China;Department of General Surgery,the 900th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Fuzhou 350001,Fujian,China;Department of General Surgery,Dongfang Hospital,Xiamen University,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学福总临床医学院,福建福州350001 [2]解放军联勤保障部队第九〇〇医院普通外科,福建福州350001 [3]厦门大学东方医院普通外科,福建福州350001

出　　处：《血管与腔内血管外科杂志》2023年第9期1044-1048,共5页Journal of Vascular and Endovascular Surgery

基　　金：福建省自然科学基金面上项目(2023J01206);第九〇〇医院院内课题重点项目(2023ZS01);全军医学科技青年培育项目(21QNPY138)。

摘　　要：目的探讨日间手术模式下不同方法治疗大隐静脉曲张的临床疗效。方法收集2020年1月至2021年1月解放军联勤保障部队第九〇〇医院收治的47例大隐静脉曲张患者的临床资料,根据治疗方式的不同将其分为对照组(n=27,采用大隐静脉高位结扎分段剥脱术+泡沫硬化剂注射术)与观察组(n=20,采用经皮高位结扎术联合激光治疗+泡沫硬化剂注射术)。两组患者治疗前后的静脉情况采用静脉临床严重程度评分表(VCSS)进行评估,观察并记录两组患者术后并发症发生情况,比较两组患者诊疗满意度。结果观察组患者手术时间短于对照组患者,术中出血量少于对照组患者,治疗满意度评分高于对照组患者,住院费用高于对照组患者,两组患者治疗后6个月VCSS评分均较治疗前明显降低,且治疗后6个月观察组患者的VCSS评分低于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者住院时间比较,差异无统计学意义(P﹥0.05)。两组患者术后均未出现严重并发症和神经损伤,对照组中仅1例患者术后发生浅静脉炎,经换药、服用改善循环药物等对症治疗后得到有效缓解。结论日间手术模式下泡沫硬化剂聚多卡醇+大隐静脉高位结扎联合激光治疗大隐静脉曲张的术后快速康复效果,与传统大隐静脉高位结扎分段剥脱术相似,疗效确切,医疗费用较低,疼痛程度较轻,安全性较高,患者满意度高,值得临床推广。Objective To analyze the clinical efficacy of different methods in the treatment of great saphenous varicose veins under daytime surgery mode.Method Clinical data of 47 patients with great saphenous varicose veins admitted in the 900th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2020 to January 2021 were collected,and all patients were divided into control group(n=27,treated with high saphenous vein ligation and segmental stripping+foam sclerotherapy injection)and observation group(n=20,treated with percutaneous high ligation combined with laser therapy+foam sclerotherapy injection)according to different treatment methods.The venous conditions of the two groups before and after treatment were evaluated using the venous clinical severity score(VCSS),the postoperative complications of the two groups were observed and recorded,and the treatment satisfaction of the two groups was compared.Result The operation time and intraoperative blood loss in the observation group were lower than those in the control group,hospitalization cost higher than that of the control group,and VCSS 6 months after operation in both group decreased than those before operation,with lower VCSS in the observation group than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the length of hospital stay(P>0.05).Both groups of patients did not experience serious complications or nerve damage after surgery,in the control group,only one patient developed superficial phlebitis after surgery,which was effectively relieved after symptomatic treatment such as changing dressing and taking medication to improve circulation.Conclusion Polidocanol foam sclerotherapy combined with high saphenous vein ligation and laser therapy in the treatment of great saphenous varicose veins under daytime surgery mode can achieve rapid postoperative rehabilitation effect similar to that of traditional high saphenous vein ligation piecewise stripping

关 键 词：日间手术 高位结扎 激光治疗 泡沫硬化剂 聚多卡醇 

分 类 号：R543[医药卫生—心血管疾病]