大隐静脉主干射频消融术联合硬化剂注射及点状剥脱术治疗原发性大隐静脉曲张的效果分析  

Effect of radiofrequency ablation of great saphenous vein trunk combined with sclerosing agent injection and punctate exfoliation in the treatment of primary great saphenous varicose veins

作　　者：单绍银 童垣皓 刘超 SHAN Shaoyin;TONG Yuanhao;LIU Chao(Department of Thoracic Surgery,Nanjing Mingji Hospital,Nanjing 210000,China)

机构地区：[1]南京市明基医院血管外科,210000

出　　处：《心肺血管病杂志》2024年第9期950-956,共7页Journal of Cardiovascular and Pulmonary Diseases

基　　金：江苏省卫生健康行业科研项目(21A200245)。

摘　　要：目的:探究大隐静脉主干射频消融术联合硬化剂注射及点状剥脱术治疗原发性大隐静脉曲张的效果。方法:随机抽取本院血管外科收治的102例原发性大隐静脉曲张患者为研究对象,按照简单随机法分为对照组(n=51)和试验组(n=51)。对照组采用大隐静脉高位结扎剥脱术联合曲张浅静脉点状剥脱术,试验组采用大隐静脉主干射频消融术联合硬化剂注射及点状剥脱术。对比两组患者的手术时间、术后24h的数字疼痛评分(numerical rating scale,NRS)、住院时间,术后7天内并发症发生率,术前、术后1个月的静脉临床表现严重程度评分(venous clinical severity score,VCSS)和慢性静脉功能不全问卷(chronic venous insufficiency questionnaire-14,CIVIQ-14)评分,术前、术后7天的凝血功能[纤维蛋白原(fibrinogen,Fib)、纤溶酶原激活物抑制物(plasminogen activator inhibitor-1,PAI-1)],术后2年复发情况。结果:两组手术时间对比差异无统计学意义(P>0.05),试验组患者的术后24h的NRS评分、住院时间均低于对照组(P<0.05);试验组患者术后1周内并发症发生率较对照组低(P<0.05);术后1个月,试验组VCSS评分较对照组低,CIVIQ-14评分较对照组高(P<0.05);术后7天试验组Fib、PAI-1水平均较对照组低(P<0.05);试验组复发率低于对照组,但差异无统计学意义(P> 0.05)。结论:大隐静脉主干射频消融术联合硬化剂注射及点状剥脱术治疗原发性大隐静脉曲张,可缩短手术时间、降低术后24h疼痛程度,减少住院时间和并发症发生率,减轻静脉临床表现严重程度以及慢性静脉功能不全程度,改善凝血功能,值得临床推广应用。Objective:To explore the effect of radiofrequency ablation of great saphenous vein trunk combined with sclerosing agent injection and punctate exfoliation in the treatment of primary great saphenous varicose veins.Methods:A total of 102 patients with primary great saphenous varicose veins admitted to department of vascular surgery of our hospital were randomly collected as the research subjects.According to the simple randomization method,the patients were divided into control group(n=51) and trial group(n=51).The control group was treated with radiofrequency ablation of great saphenous vein trunk,and the trial group was given radiofrequency ablation of great saphenous vein trunk combined with sclerosing agent injection and punctate exfoliation.The surgical time,numerical rating scale(NRS) at 24 hours after surgery,hospital stay,incidence of postoperative complications,venous clinical severity score(VCSS) and chronic venous insufficiency questionnaire-14(CIVIQ-14) before surgery and at 1 month after surgery,coagulation function [fibrinogen(Fib),plasminogen activator inhibitor-1(PAI-1)] before surgery and at 7 days after surgery and recurrence at 6 months after surgery were compared between two groups of patients.Results:There was no difference in the surgical time between the two groups(P>0.05).The NRS score at 24 hours after surgery and hospital stay in trial group were lower or shorter than those in control group(P<0.05).The incidence rate of complications within 7 days after surgery was lower in trial group than that in control group(P<0.05).At 1month after surgery,the VCSS score in trial group was lower than that in control group while the CIVIQ-14score was higher than that in control group(P<0.05).The levels of Fib and PAI-1 in trial group at 7 days after surgery were lower compared with those in control group(P<0.05).The recurrence rate in trial group was lower compared to control group(P>0.05).Conclusions:Radiofrequency ablation of great saphenous vein trunk combined with sclerosing agent injection and pun

关 键 词：射频消融术 大隐静脉曲张 硬化剂注射 点状剥脱术 效果 

分 类 号：R54[医药卫生—心血管疾病]