下肢静脉曲张微创治疗现状及评价  

Current status and evaluation of minimally invasive treatment for lower extremity varicose veins

作　　者：何楠[1] 张腾飞[1] 梁紫轲 荣智华 赵浩阳 陈忠[1] HE Nan;ZHANG Teng-fei;LIANG Zi-ke(Department of Vascular,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院血管外科中心,北京100029

出　　处：《中国实用外科杂志》2023年第12期1364-1368,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82000449)。

摘　　要：下肢静脉曲张是一种常见的下肢血管疾病,多见于需要长时间站立或从事体力劳动的人群,且存在家族聚集性。我国下肢静脉疾病的患病率约为8.89%,每年新发病率为0.5%~3.0%,其中静脉性溃疡占1.5%,并呈现年轻化趋势。该疾病晚期将严重影响病人的生活质量,可导致静脉炎、静脉血栓和下肢静脉性溃疡等并发症。随着微创治疗技术的发展,目前基本已可取代传统的大隐静脉高位结扎剥脱术,成为首选治疗方式。下肢静脉曲张微创治疗主要包括静脉腔内射频消融(RFA)、静脉腔内激光闭合术(EVLA)、腔内微波消融(EVMA)、泡沫硬化疗法(UGFS)、Tri Vex微创旋切术(TIMIC)、氰基丙烯酸酯栓塞术(CGE)和机械力化学消融(MOCA)等。其具有手术简便、术后恢复迅速、较低并发症风险等优势,在改善病人的生活质量和减轻临床症状方面表现出巨大的潜力。目前临床已有诸多微创手术方式可供选择,可根据不同病情制定个体化治疗方案。Lower limb varicose veins are a common vascular disease,particularly prevalent among individuals who need to stand for extended periods or engage in physical labor,and often exhibit familial clustering.In China,the prevalence of lower limb venous diseases is approximately 8.89%,with an annual incidence ranging from 0.5% to 3.0%.Venous ulcers account for 1.5% of cases and show a trend towards affecting younger individuals.In the advanced stages,this condition significantly impacts patients' quality of life and can lead to complications such as venous inflammation,thrombosis,and lower limb venous ulcers.With the advancement of minimally invasive treatment techniques,traditional procedures like high ligation and stripping of the great saphenous vein are now largely replaced.Minimally invasive treatments for lower limb varicose veins primarily include endovenous radiofrequency ablation(RFA),endovenous laser ablation(EVLA),endovenous microwave ablation(EVMA),foam sclerotherapy(UGFS),Tri Vex minimally invasive rotational incision technique(TIMIC),cyanoacrylate embolization(CGE),and mechanochemical ablation(MOCA).These approaches offer advantages such as simplicity of surgery,rapid postoperative recovery,and a lower risk of complications.They demonstrate significant potential in enhancing patients' quality of life and alleviating clinical symptoms.Currently,a variety of minimally invasive surgical methods are available,allowing for the development of personalized treatment plans based on different disease conditions.

关 键 词：下肢静脉曲张 微创治疗 静脉腔内射频消融 静脉腔内激光闭合术 腔内微波消融 泡沫硬化剂 氰基丙烯酸酯栓塞术 机械力化学消融 

分 类 号：R6[医药卫生—外科学]