应用各种射频消融系统治疗下肢慢性静脉功能不全评价  

The value and evaluation of various radiofrequency ablation of chronic venous insufficiency

作　　者：蒋劲松[1] 卢凯平[1] JIANG Jin-song;LU Kai-ping(Department of Vascular Surgery,Zhejiang Provincial People's Hospital,Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院血管外科杭州医学院,浙江杭州310114

出　　处：《中国实用外科杂志》2023年第12期1368-1372,共5页Chinese Journal of Practical Surgery

基　　金：浙江省教育厅一般科研项目(No.Y202044641)。

摘　　要：下肢静脉曲张是慢性静脉功能不全(CVI)的重要组成部分,目前针对C2级以上下肢静脉曲张的手术治疗正逐渐从传统的大(小)隐静脉高位结扎+抽剥术过渡到以腔内热闭合为主的各种微创术式,而射频消融术(RFA)因其具有操作的标准化及疗效的一致性被公认为热闭合的主流术式。在取得和传统开放手术同等疗效的前提下,射频治疗具有手术时间短、恢复快、微创美观等临床优势。RFA的安全性主要取决于对周围组织的热损伤程度和范围,不同类型的射频消融系统在工作温度、加热周期、加热段长度、导管直径、工作频率等方面有所差异,影响着射频消融的效果和副反应。目前主流使用的射频消融系统主要有ClosureFast?、Celon RFiTT?、F Care?3种进口系统,以及AcoArt Cedar?、V-Cure?、ZYLOX Swan?、J-Vena?、VenousRF 100?5种国产系统,各有各的特性和区别,需要术者根据具体情况选择合适的系统。国产射频消融系统在近年来得到了快速发展和临床认可,其安全性和疗效基本与经典射频方案等同,且在操作方式和闭合原理上作了一些改进和创新,具有较强的实用性和竞争力。Lower extremity varicose veins are an important part of chronic venous insufficiency(CVI),and the surgical treatment of varicose veins of the lower extremities above stage C2 is gradually transitioning from the traditional large(small)saphenous vein high ligation + abrasion to various minimally invasive procedures based on intraluminal thermal closure,while radiofrequency ablation(RFA)is recognized as the mainstream surgical method of thermal closure because of its standardized operation and consistency of efficacy.Under the premise of achieving the same efficacy as traditional open surgery,radiofrequency therapy has clinical advantages such as short operation time,fast recovery,and minimally invasive aesthetics.The safety of radiofrequency ablation(RFA) primarily depends on the extent and degree of heat damage to surrounding tissues and organizations.Different types of RFA systems vary in factors such as operating temperature,heating cycle,heating segment length,catheter diameter,operating frequency,etc.,which impact the effectiveness and adverse reactions of the RFA procedure.Currently,widely used imported RFA systems include ClosureFast?,Celon RFiTT?,and F Care?.There are also five domestic systems:AcoArt Cedar?,V-Cure?,ZYLOX Swan?,J-Vena?,and VenousRF 100?.Each system has its characteristics and differences,and it is essential for the operator to choose an appropriate system based on specific situations.Domestic RFA systems have experienced rapid development and gained clinical recognition in recent years.They demonstrate safety and efficacy comparable to classical RFA approaches.Moreover,these systems have made some improvements and innovations in operational methods and closure principles,enhancing their practicality and competitiveness.

关 键 词：慢性静脉功能不全 下肢静脉曲张 射频消融术 

分 类 号：R6[医药卫生—外科学]