大隐静脉高位结扎联合静脉腔内激光术+低分子肝素或利伐沙班治疗股腘深静脉反流的疗效对比  

Comparison of therapeutic effects of high ligation of great saphenous vein combined with intravenous laser+low molecular weight heparin or rivaroxaban in the treatment of deep femoral and popliteal venous reflux

作　　者：杜建青[1] 张弘[1] 吴忠隐 李荣华[1] 汪立[1] Du Jianqing;Zhang Hong;Wu Zhongyin;Li Ronghua;Wang Li(Department of Vascular Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,china)

机构地区：[1]承德医学院附属医院血管外科,河北承德067000

出　　处：《血管与腔内血管外科杂志》2024年第4期485-488,501,共5页Journal of Vascular and Endovascular Surgery

基　　金：承德市科学技术研究与发展计划项目(202006A082)。

摘　　要：目的探讨大隐静脉高位结扎联合静脉腔内激光术+低分子肝素或利伐沙班治疗股腘深静脉反流的临床疗效和安全性。方法收集2020年1月至2022年1月承德医学院附属医院收治的200例股腘深静脉反流患者的临床资料。按照治疗方法的不同将其分为对照组(n=100,采用大隐静脉高位结扎联合静脉腔内激光术+低分子肝素治疗)和观察组(n=100,采用大隐静脉高位结扎联合静脉腔内激光术+利伐沙班治疗)。比较两组患者静脉临床严重程度(VCSS)、手术前后劳动能力丧失程度、生活质量及术后和随访期间并发症发生情况。结果术后,观察组患者静脉临床严重程度评分(VCSS)、劳动能力丢失评分(VDS)均低于对照组患者,下肢慢性静脉功能不全问卷(CIVIQ)评分高于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率低于对照组患者,差异有统计学意义(P﹤0.05)。结论大隐静脉高位结扎联合静脉腔内激光术+利伐沙班治疗股腘深静脉反流的临床疗效优于大隐静脉高位结扎联合静脉腔内激光术+低分子肝素,安全性较高,可显著改善患者治疗后劳动力、生活质量,有较高的临床应用价值。Objective To investigate the clinical efficacy and safety of high ligation of great saphenous vein combined with intravenous laser+low molecular weight heparin or rivaroxaban in the treatment of femoral and popliteal deep vein reflux.Method Clinical data of 200 patients with femoral and popliteal deep venous reflux admitted to the Affiliated Hospital of Chengde Medical College from January 2020 to January 2022 were collected.According to the different treatment methods,they were divided into control group(n=100,treated with high ligation of great saphenous vein combined with intravenous laser+low molecular weight heparin)and observation group(n=100,treated with high ligation of great saphenous vein combined with intravenous laser+rivaroxaban).The venous clinical severity score(VCSS),the degree of labor loss before and after surgery,quality of life,complications during postoperative and follow-up were compared between the two groups.Result After surgery,the VCSS and verification of disability score(VDS)of observation group were lower than those of control group,the chronic venous insufficiency questionnaire(CIVIQ)scores of lower extremity were higher than those of control group,the differences were statistically significant(P<0.05).The total incidence of complications in observation group was lower than that in control group,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of high ligation of great saphenous vein combined with intravenous laser+rivaroxaban in the treatment of femoral and popliteal deep vein reflux is superior to that of high ligation of great saphenous vein combined with intravenous laser+low molecular weight heparin,with high safety,which can significantly improve the labor force and quality of life of patients after treatment,and has high clinical application value.

关 键 词：大隐静脉高位结扎联合静脉腔内激光术 低分子肝素 利伐沙班 股腘深静脉反流 

分 类 号：R543[医药卫生—心血管疾病]