大隐静脉高位结扎剥脱术联合泡沫硬化疗法治疗下肢静脉曲张的疗效与安全性  

Efficacy and safety of high ligation and stripping of great saphenous vein combined with foam sclerotherapy for varicose vein of lower extremity

作　　者：方志宏 刘庆 康友根 杨璞[2] Fang Zhihong;Liu Qing;Kang Yougen;Yang Pu(Department of Intervention,Xiangtan Central Hospital,Xiangtan 411100,Hu'nan,China;Department of Vascular Surgery,Xiangya Hospital,Central South University,Changsha 410003,Hu'nan,China)

机构地区：[1]湘潭市中心医院介入科,湖南湘潭411100 [2]中南大学湘雅医院血管外科,湖南长沙410003

出　　处：《血管与腔内血管外科杂志》2023年第11期1327-1330,1336,共5页Journal of Vascular and Endovascular Surgery

基　　金：湖南省自然科学基金项目(2023JJ30961)。

摘　　要：目的 探讨大隐静脉高位结扎剥脱术联合泡沫硬化疗法(FS)治疗下肢静脉曲张(VVLE)的疗效与安全性。方法 收集2020年3月至2021年11月湘潭市中心医院收治的进行下肢静脉手术治疗的88例中重度VVLE患者(98条患肢)的临床资料,根据手术方式的不同将患者分为联合组(n=41,采用大隐静脉高位结扎剥脱术联合FS)和对照组(n=47,采用大隐静脉高位结扎剥脱术治疗)。比较两组的手术相关指标(手术时间、术中出血量)、住院时间、反流复发率和术后并发症发生情况。采用静脉临床严重程度评分(VCSS)和阿伯丁静脉曲张问卷(AVVQ)分别评估并比较两组患者术前、术后6个月静脉曲张的严重程度和生活质量。结果 联合组患者的手术时间和住院时间均明显短于对照组患者,术中出血量明显少于对照组患者,差异均有统计学意义(P﹤0.01)。术后1、6个月,两组患者的反流复发率比较,差异均无统计学意义(P﹥0.05)。术后1个月,联合组患者切口感染、下肢深静脉血栓形成的发生率均低于对照组患者,差异均有统计学意义(P﹤0.05)。术后6个月,联合组患者的VCSS、AVVQ评分均低于对照组患者,差异均有统计学意义(P﹤0.05)。结论 大隐静脉高位结扎剥脱术联合FS治疗中重度VVLE的效果良好,有助于改善手术指标,缩短住院时间,降低术后并发症发生率,改善患者的术后生活质量。Objective To investigate the efficacy and safety of high ligation and stripping of great saphenous vein combined with foam sclerotherapy in the treatment of varicose vein of lower extremity(VVLE).Method The clinical data of 88 patients with moderate and severe VVLE(98 affected extremities)who underwent lower extremity venous surgery at Xiangtan Central Hospital from March 2020 to November 2021 were collected.The patients were divided into the combination group(n=41,treated with high ligation and stripping of the great saphenous vein combined with foam sclerotherapy injection)and the control group(n=47,treated with high ligation and stripping of the great saphenous vein)according to different surgical methods.The surgery-related indicators(operation time,intraoperative blood loss),length of hospital stay,reflux recurrence rate,and postoperative complications were compared between the two groups.The venous clinical severity score(VCSS)and the Aberdeen varicose vein questionnaire(AVVQ)were used to evaluate and compare the severity of varicose veins and quality of life between the two groups of patients before and six months after the surgery.Result The operation time and hospitalization time of the patients in the combination group were significantly shorter than that of the patients in the control group,and the intraoperative blood loss was significantly less than that of the patients in the control group,and the differences were statistically significant(P﹤0.01).There were no statistically significant difference in the reflux recurrence rate between the two groups of patients one and six months after the surgery(P﹥0.05).The incidence rates of incision infection and deep vein thrombosis of the lower extremity in the combination group one month after the surgery were lower than those in the control group,and the differences were statistically significant(P﹤0.05).Six months after the surgery,the VCSS and AVVQ scale scores of the patients in the combination group were lower than those of the control group,and th

关 键 词：大隐静脉高位结扎剥脱术 泡沫硬化疗法 下肢静脉曲张 临床疗效 

分 类 号：R543[医药卫生—心血管疾病]