术中静脉造影在原发性下肢浅静脉曲张激光闭合术中的应用  

Endovenous laser closure treatment of superficial varicose veins in the lower extremity guided by intraoperative phlebography

作　　者：范伟健 唐明 刘庆玲 殷世武 Fan Weijian;Tang Ming;Liu Qingling;Yin Shiwu(Department of Interventional Vascular Pain,Hefei Hospital Affiliated to Anhui Medical University(the Second People's Hospital of Hefei),Hefei 230011,Anhui,China;Department of General Medicine,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China)

机构地区：[1]安徽医科大学附属合肥医院(合肥市第二人民医院)介入血管疼痛科,安徽合肥230011 [2]兰州大学第二医院全科医学科,甘肃兰州730030

出　　处：《血管与腔内血管外科杂志》2024年第5期524-528,544,共6页Journal of Vascular and Endovascular Surgery

基　　金：青年科研基金(2021yqn14)。

摘　　要：目的探讨术中静脉造影引导下的原发性下肢浅静脉曲张激光闭合术的治疗效果。方法收集2020年7月至2022年6月安徽医科大学附属合肥医院(合肥市第二人民医院)收治的127例原发性下肢浅静脉曲张患者的临床资料,所有患者均接受术中静脉造影引导下的下肢浅静脉曲张激光闭合术,记录所有患者的临床特征、辐射剂量、照射时间、肾功能及并发症发生情况,采用血管超声评估大隐静脉主干闭合程度。结果127例患者均于全身麻醉或局部麻醉下顺利实施手术,手术成功率为100%。术中所接受的平均辐射剂量(6.72±1.68)m Gy,平均照射时间为(106.66±26.65)s,平均造影剂用量为(22.85±15.55)ml。手术前后血肌酐、血尿素氮水平比较,差异均无统计学意义(P﹥0.05)。激光相关并发症中,感觉异常5例,静脉闭合127例,皮肤灼伤1例。无血栓性静脉炎、皮下淤血、下肢深静脉血栓等并发症发生。结论对于原发性下肢浅静脉曲张患者,术中静脉造影引导下的下肢浅静脉曲张激光闭合术安全性高,治疗效果好。Objective To explore the therapeutic efficacy of intraoperative phlebography-guided endovenous laser closure treatment of superficial varicose veins in the lower extremity.Method The clinical data of 127 patients with primary superficial varicose veins in the lower extremities admitted to Hefei Hospital Affiliated to Anhui Medical University(the Second People's Hospital of Hefei)from July 2020 to June 2022 were collected,all patients underwent laser closure of superficial varicose veins in the lower extremities guided by intraoperative phlebography.Result A total of 127 patients underwent surgery successfully under general anesthesia or local anesthesia,and the success rate of surgery was 100%.The average intraoperative radiation dose was(6.72±1.68)mGy,the average irradiation periods was(106.66±26.65)s,and the average contrast agent dosage was(22.85±15.55)ml.There were no statistically significant differences in blood creatinine level and blood urea nitrogen level before and after surgery(P>0.05).Among the laser related complications,there were 5 cases of sensory abnormalities,127 cases of venous closure,and 1 case of skin burns.No complications such as thrombophlebitis,subcutaneous congestion,and deep vein thrombosis in the lower extremities occurred.Conclusion For patients with primary superficial varicose veins in the lower extremities,intraoperative phlebography-guided endovenous laser closure treatment of superficial varicose veins in the lower extremities was a safe and effective treatment method with promising outcomes.

关 键 词：腔内激光闭合术 静脉曲张 静脉造影术 治疗效果 

分 类 号：R543[医药卫生—心血管疾病]