静脉腔内热消融术治疗下肢静脉曲张研究进展  

Research progress of endovenous thermal ablation in treating lower extremity varicose veins

作　　者：杨纯旭 张玥[2] 匡英杰 刘效敏[3] Yang Chunxu;Zhang Yue;Kuang Yingjie;Liu Xiaomin(The First Clinical Medicine School,Shandong University of Traditional Chinese Medicine,Ji'nan 250014,China;Department of Peripheral Vascular Disease,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan 250014,China;Department of Orthopedics for Sports Injury,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,济南250014 [2]山东中医药大学附属医院周围血管病科,济南250014 [3]山东中医药大学附属医院运动损伤骨科,济南250014

出　　处：《中国医学装备》2024年第8期176-181,共6页China Medical Equipment

摘　　要：下肢静脉曲张在静脉系统疾病中的发病率较高,手术治疗是下肢静脉曲张的主要治疗方式。随着医学技术的进步和微创理念的发展,静脉腔内热消融术(EVTA)以其创伤小、术后恢复快、并发症发生率低、闭合率高等特点,成为下肢静脉曲张治疗指南中的首选推荐术式。EVTA主要包括腔内射频消融术(RFA)、腔内激光消融术(EVLA)和腔内微波消融术(EMA),通过不同的热消融设备施加热量于目标血管,以热能破坏血管内皮细胞和管壁胶原纤维,使管腔收缩形成纤维条索,从而达到闭合目标血管的目的。不同的EVTA术式作用机制、治疗效果以及并发症发生率不同,在应用范围上也有所区别。综述EVTA常见术式及近5年的临床应用,为合理选择热消融术式及设备提供参考,为预防热损伤并发症提供帮助。The incidence of lower extremity varicose veins is higher in the disease of venous system,and surgical treatment is the main treatment method of lower extremity varicose veins.With the advancement of technique and the development of minimally invasive concept,endovenous thermal ablation(EVTA)has become the first choice in the guidance of the treatment of lower extremity varicose veins depended on its series of advantages include small trauma,rapid recovery after surgery,low incidence of complication and high closure rate.At present,EVTA mainly includes intracavitary radiofrequency ablation(RFA),endovenous laser ablation(EVLA)and endovenous microwave ablation(EMA),which takes heat on target vessel through different thermal ablation equipment,and uses thermal energy to destruct the endothelial cells of blood vessel and collagen fibers in the vascular wall.Then,the contracted lumen forms the fibrous strands,thus reaches the aim that closes target vessel.Different EVTA surgical mode has different mechanism of action,therapeutic effect and incidence of complication,as well as the application range.This paper summarized the routinely surgical mode of EVTA and the clinical application of that in the past 5 years,which can provide references for reasonable choosing the mode of thermal ablation and the equipment,and can provide helps for preventing the complication of thermal injury.

关 键 词：下肢静脉曲张 静脉腔内热消融术(EVTA) 腔内射频消融术(RFA) 腔内激光消融术(EVLA) 腔内微波消融术 热损伤 

分 类 号：R164.4[医药卫生—公共卫生与预防医学]