大隐静脉主干高位结扎联合腔内射频消融治疗大隐静脉曲张的疗效  

The efficacy of high ligation of great saphenous vein combined with intracavitary radiofrequency ablation in the treatment of great saphenous varicose veins

作　　者：厉胜 晋炳申 LI Sheng;JIN Bing-shen(Department of Cardiovascular Surgery,Beijing Shijingshan Hospital,Shijingshan Teaching Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学石景山教学医院·北京石景山医院心胸血管外科,北京100043

出　　处：《川北医学院学报》2024年第2期190-193,共4页Journal of North Sichuan Medical College

基　　金：北京市科学技术委员会科研计划项目(D151100004913021)。

摘　　要：目的:探讨大隐静脉主干高位结扎联合腔内射频消融治疗大隐静脉曲张的疗效。方法:将80例大隐静脉曲张患者按手术方式不同分为射频消融组(n=40)和剥脱组(n=40)。射频消融组采用高位结扎联合腔内射频消融治疗;剥脱组采用高位结扎联合剥脱术治疗。比较两组患者临床疗效、手术一般情况、应激指标和术后并发症及术后1年复发情况。结果:两组患者治疗总有效率比较,差异无统计学意义(P>0.05);相比剥脱组,射频消融组手术切口数和术中出血量更少(P<0.05),手术时间和术后住院时间更短(P<0.05)。术后24 h,两组IL-6、TNF-α均高于术前(P<0.05),但射频消融组均低于剥脱组(P<0.05)。射频消融组术后创面感染、瘀斑、疼痛和复发情况低于剥脱组(P<0.05)。射频消融组术后并发症总发生率低于剥脱组(P<0.05);术后1年复发率为5.00%,低于剥脱组的22.50%(P<0.05)。结论:大隐静脉主干高位结扎联合射频消融在治疗大隐静脉曲张中效果确切,具有创伤小、术后恢复快、并发症少和复发率低的优势。Objective:To explore the efficacy of high ligation of great saphenous vein combined with intracavitary radiofrequency ablation in the treatment of great saphenous varicose veins.Methods:A total of 80 patients were divided into radiofrequency ablation group(n=40)and stripping group(n=40)according to the different surgical methods.The radiofrequency ablation group was treated with high ligation combined with intracavitary radiofrequency ablation,and the stripping group was treated with high ligation combined with stripping.The clinical efficacy,general conditions of operation,stress indicators,postoperative complications and recurrence at 1 year after operation were compared between the two groups.Results:There was no significant difference between the two groups(P>0.05).Compared with the stripping group,the number of surgical incisions and intraoperative blood loss in the radiofrequency ablation group were less(P<0.05),and the operation time and postoperative hospital stay were shorter(P<0.05).At 24 h after operation,the levels of IL-6 and TNF-αin the two groups were higher than those before operation(P<0.05),but those in the radiofrequency ablation group were lower than those in the stripping group(P<0.05).The postoperative wound infection,ecchymosis,pain and recurrence in the radiofrequency ablation group were lower than those in the stripping group(P<0.05).Compared with the stripping group,the total incidence of postoperative complications in the radiofrequency ablation group was lower(P<0.05).The 1-year recurrence rate of the radiofrequency ablation group was 5.00%,which was lower than 22.50%of the stripping group(P<0.05).Conclusion:High ligation of great saphenous vein combined with radiofrequency ablation is effective in the treatment of great saphenous varicose veins.It has the advantages of less trauma,rapid postoperative recovery,less complications and low recurrence rate.

关 键 词：大隐静脉 高位结扎 射频消融 剥脱术 疗效 

分 类 号：R654.3[医药卫生—外科学]