碳酸氢钠在大隐静脉曲张射频消融术中的应用价值  

Application value of sodium bicarbonate in radiofrequency ablation of great saphenous vein varices

作　　者：董娜[1] 刘君 陈修翠 刘雯雯[1] 张杰[2] Dong Na;Liu Jun;Chen Xiucui;Liu Wenwen;Zhang Jie(Operating Room,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Department of Vascular Surgery,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院手术室,北京101149 [2]首都医科大学附属北京潞河医院血管外科,北京101149

出　　处：《血管与腔内血管外科杂志》2024年第6期734-738,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨碳酸氢钠(NaHCO_(3))在大隐静脉曲张射频消融术中的应用价值。方法收集2022年1―12月于首都医科大学附属北京潞河医院接受射频消融术治疗的290例大隐静脉曲张患者的临床资料,按照术中是否使用了NaHCO_(3)将患者分为NaHCO_(3)组(n=139)和对照组(n=151)。比较两组患者的大隐静脉曲张专科信息[病程、临床表现-病因学-解剖学-病理生理学(CEAP)分级]、手术相关指标(手术时间、术中出血量)、围手术期手术部位视觉模拟评分法(VAS)评分和住院期间手术相关并发症发生情况。结果两组患者的病程、CEAP分级、手术时间和术中出血量比较,差异均无统计学意义(P﹥0.05)。NaHCO_(3)组患者注射麻醉肿胀液时、射频治疗时、术后1 h、术后6 h的VAS评分均明显低于对照组患者,差异均有统计学意义(P﹤0.01);两组患者术后24 h的VAS评分,住院期间局部血肿、隐神经损伤、皮肤灼伤的发生率,以及术前、术后次日的尿液酸碱值(pH)比较,差异均无统计学意义(P﹥0.05)。结论在采用射频消融术治疗大隐静脉曲张时,在麻醉肿胀液中加入NaHCO_(3)有利于减轻患者围手术期手术部位的疼痛感,同时没有增加住院期间手术相关并发症的发生风险。Objective To investigate the application value of sodium bicarbonate(NaHCO_(3))in radiofrequency ablation of great saphenous vein varices.Method The clinical data of 290 patients with great saphenous vein varices who underwent radiofrequency ablation treatment at Beijing Luhe Hospital,Capital Medical University from January to December 2022 were collected.The patients were divided into NaHCO_(3) group(n=139)and control group(n=151)based on whether NaHCO_(3) was used during the surgery.The specialized information related to great saphenous vein varices[disease course,clinical etiology anatomy pathophysiology(CEAP)grading],surgical related indicators[surgical time,intraoperative bleeding volume],perioperative visual analogue scale(VAS)scores of perioperative surgical sites,and incidence of surgical related complications were compared between two groups of patients.Result There were no statistically significant differences in the course of disease,CEAP grading,surgical time,and intraoperative bleeding between the two groups of patients(P>0.05).The VAS scores of patients in the NaHCO_(3) group were significantly lower than those in the control group during injection of anesthesia swelling solution,radiofrequency therapy,postoperative 1 h,and postoperative 6 h,and the differences were statistically significant(P<0.01).There were no statistically significant differences in the VAS scores of the two groups of patients 24 h after surgery,the incidence of local hematoma during hospitalization,the incidence of saphenous nerve injury during hospitalization,and the incidence of skin burns during hospitalization,as well as the urine pondus hydrogenii(pH)values before and the day after surgery(P>0.05).Conclusion When using radiofrequency ablation to treat great saphenous vein varices,adding NaHCO_(3) to the anesthesia swelling solution is beneficial for reducing the pain at the surgical site during the perioperative period,while not increasing the risk of surgical complications during hospitalization.

关 键 词：碳酸氢钠 大隐静脉曲张 射频消融术 并发症 

分 类 号：R543[医药卫生—心血管疾病]