双极射频消融导管治疗穿通支静脉功能不全129例临床研究  

Treatment of incompetent perforating veins using endovenous bipolar radiofrequency ablation:a retrospective study of 129 cases

作　　者：陈磊 卢凯平[1] 吴昊[1] 蒋劲松[1] CHEN Lei;LU Kai-ping;WU Hao;JIANG Jin-song(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1398-1401,共4页Chinese Journal of Practical Surgery

基　　金：浙江省教育厅一般科研项目(No.Y202044641)。

摘　　要：目的 探讨双极射频消融导管治疗功能不全的穿通支静脉的操作方法并评价疗效。方法 回顾性分析2017年5月至2022年5月在浙江省人民医院接受双极射频消融导管(Celon ProCurve 1200-S15)治疗的129例下肢静脉曲张病人(包含171条肢体,378条功能不全的穿通支静脉),同时评估随访期间的临床疗效数据。结果射频闭合治疗穿通支静脉的手术成功率为89.9%(340/378),术中38条未能成功治疗的穿通支均位于小腿后侧。全部病人随访至12个月,超声评估340条穿通支静脉的闭合率为90.5%(308/340)。随访期间静脉临床严重程度评分(VCSS)显著改善(P值均<0.001)。9条患肢术后出现局部感觉异常,均自行消退,同时未出现皮肤烧伤、深静脉血栓等严重术后并发症。结论 使用双极射频消融导管治疗功能不全的穿通支静脉是一种有效且安全的方法。并且可以同期治疗功能不全的大隐静脉。但在常规手术体位下,部分穿通支静脉的治疗难度较大,尤其是当其位于小腿后侧区域。Objective Assessment of the use of the method in the treatment of incompetent perforating veins(IPVs)using bipolar radiofrequency ablation(RFA).Methods This study retrospectively analyses 129 patients(171 limbs,378IPVs)treated with a bipolar radiofrequency catheter(Celon ProCurve 1200-S15)in Zhejiang Provincial People's Hospital from May 2017 to May 2022 and the follow-up data for clinical efficacy evaluation.Patients with incompetent great saphenous veins(GSV)or small saphenous veins(SSV)underwent ablation treatment simultaneously using the same catheter.Results The success rate of the operation was 89.9%(340/378).All of the 38 failed closure IPVs were lying in the posterior calf.Among the patients who completed the 12-month follow-up visit,the closure rate of 340 IPVs obtained by ultrasound was 90.5%(308/340).All components of the Venous Clinical Severity Score(VCSS)were significantly improved at each postprocedural visit(P<0.001 for all).9 treated limbs had localized paresthesia,which subsided spontaneously,with no serious complications such as skin burns and deep vein thrombosis(DVT).Conclusion Using this bipolar radiofrequency catheter to close IPVs is an effective and safe treatment.At the same time,it can treat the incompetent GSV or SSV in one stage.However,it is hard to treat the IPVs located in the back area of the lower leg.

关 键 词：穿通支静脉 射频消融 双极射频导管 

分 类 号：R6[医药卫生—外科学]